A cost-effectiveness approach to the Norwegian follow-up programme in colorectal cancer

Background: Today, continued periodic follow-up of patients treated for colorectal cancer (CRC) seems often to be routine because of tradition, rather than its demonstrated value. Recently the Norwegian Gastrointestinal Cancer Group (NGICG) has recommended a standard surveillance programme in this malignancy. In this protocol patients are suggested followed for four years with CEA monitoring, ultrasound of the liver, chest radiograph and colonoscopy at regular intervals. Material and methods. In this study, the cost-effectiveness of this programme was addressed employing Norwegian cost data and data from the Cancer Registry of Norway. Clinical data from the existing English language literature was used in the analysis. Results. The basic cost of the NGICG recommended programme was pound 1,232 per patient. Including extended investigation due to suspected relapse in 45% of cases, the figure raised to pound 1,943 per patient. The cost per life year saved was indicated to pound 9,525-pound 16,192. The corresponding cost per quality adjusted life year (QALY) was indicated to pound 11,476-pound 19,508. Conclusion: We conclude the NGICG recommended follow-up programme in CRC cost-effective. Excluding CEA monitoring may improve the cost-effectiveness.