Hospital Costs of Colorectal Cancer Care

OBJECTIVE In a hospital based setting, identify factors which influence the cost of colorectal cancer care? DESIGN Retrospective case note review SETTING Nottingham, United Kingdom PARTICIPANTS 227 patients treated for colorectal cancer METHODS Retrospective review of the hospital records provided the primary data for the costing study and included all CRC related resource consumption over the study period. RESULTS Of 700 people identified, 227 (32%) sets of hospital notes were reviewed. The median age of the study group was 70.3 (IQR 11.3) years and there were 128 (56%) males. At two years, there was a significant difference in costs between Dukes D cancers ( pound3641) and the other stages ( pound3776 Dukes A; pound4921 Dukes B). Using univariate and multivariate regression, the year of diagnosis, Dukes stage of disease, intensive nursing care, stoma requirements and recurrent disease all significantly affected the total cost of care. CONCLUSIONS CRC remains costly with no significant difference in costs if diagnosed before compared to after 1992. Very early and very late stage cancers remain the least costly stage of cancers to treat. Other significant effectors of hospital costs were the site of cancer (rectal), intensive nursing care, recurrent disease and the need for a stoma.