Adult urologyClinical model of lifetime cost of treating bladder cancer and associated complications
Section snippets
Material and methods
We obtained clinical and resource use data by reviewing the medical records of a retrospective cohort of 306 consecutive Houston-area patients who presented to The University of Texas M.D. Anderson Cancer Center (MDACC) with transitional cell carcinoma of the bladder from January 1, 1991 to December 31, 1999. The cohort was limited to patients who resided in the Houston area (ie, Harris County and its six contiguous counties) to ensure complete ascertainment of all costs of cancer care. Of the
Patient Characteristics and Outcomes
A total of 208 patients with bladder cancer were eligible for the analysis. Of these, 97 (47%) were younger than 65 years of age at registration, 156 (75%) were men, and 177 (85%) were white. Most, 147 patients (71%), were initially diagnosed with superficial disease (American Joint Committee on Cancer Stage 1 or lower), and the remaining 61 (29%) already had muscle-invasive disease (American Joint Committee on Cancer Stage 2 or greater) at the initial diagnosis. Of the 208 patients, 186 (89%)
Comment
Our estimates of the lifetime cost for treating bladder cancer ($65,158 for the cohort, $99,270 for the worst-case scenario and $120,684 for the best-case scenario) have indicated that the economic burden caused by the disease in patients of all ages treated at a comprehensive cancer center can be substantial. Most importantly, our study has shown that complications significantly contribute to the lifetime costs of managing bladder cancer. Almost one third of the total costs were attributed to
Conclusions
The management of bladder cancer, particularly surveillance for recurrence and the treatment of the eventual recurrences, results in major clinical and economic burdens. Complications associated with bladder cancer and its treatment contribute significantly to the disease’s lifetime costs. Identifying more cost-effective surveillance strategies and approaches for preventing bladder cancer complications is crucial to minimizing the disease’s clinical and economic consequences.
References (18)
- et al.
Bladder tumor markers beyond cytology: International Consensus Panel on Bladder Tumor Markers
Urology
(2005) - et al.
Highly specific urine-based marker of bladder cancer
Urology
(2005) - et al.
Immunocyte and the HA-HAase urine tests for the detection of bladder cancer: a side by side comparison
Eur Urol
(2004) - International Agency for Research on Cancer: GLOBOCAN 2002. Cancer incidence, mortality and prevalence worldwide. IARC...
- American Cancer Society: Cancer facts and figures 2002. Available at:...
- et al.
Localized bladder cancer
Curr Treat Options Oncol
(2000) - et al.
Epidemiology and etiology of bladder cancer
Semin Surg Oncol
(1997) - National Cancer Institute: NCI Fact Book. Available at: www3.cancer.gov/admin/fmb/03Factbk.pdf. Accessed April 12,...
- et al.
The health economics of bladder cancer: a comprehensive review of the published literature
Pharmacoeconomics
(2003)
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This study was supported, in part, by a grant from Pharmacia, Incorporated (formerly Searle).