Limits...
Estimation of Life-Year Loss and Lifetime Costs for Different Stages of Colon Adenocarcinoma in Taiwan.

Chen PC, Lee JC, Wang JD - PLoS ONE (2015)

Bottom Line: All patients were followed-up until the end of 2011.Life-expectancy, expected-years-of-life-lost and lifetime costs were estimated, using a semi-parametric survival extrapolation method and borrowing information from life tables of vital statistics.Besides, the lifetime cost of managing stage II colon cancer patients would be US $8,416 ± 1939, 14,334 ± 1,755, and 21,837 ± 1,698, respectively, indicating a big saving for early diagnosis and treatment after stratification for age and sex.

View Article: PubMed Central - PubMed

Affiliation: Division of Colorectal Surgery and General Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

ABSTRACT

Backgrounds and aims: Life-expectancy of colon cancer patients cannot be accurately answered due to the lack of both large datasets and long-term follow-ups, which impedes accurate estimation of lifetime cost to treat colon cancer patients. In this study, we applied a method to estimate life-expectancy of colon cancer patients in Taiwan and calculate the lifetime costs by different stages and age groups.

Methods: A total of 17,526 cases with pathologically verified colon adenocarcinoma between 2002 and 2009 were extracted from Taiwan Cancer Registry database for analysis. All patients were followed-up until the end of 2011. Life-expectancy, expected-years-of-life-lost and lifetime costs were estimated, using a semi-parametric survival extrapolation method and borrowing information from life tables of vital statistics.

Results: Patients with more advanced stages of colon cancer were generally younger and less co-morbid with major chronic diseases than those with stages I and II. The LE of stage I was not significantly different from that of the age- and sex-matched general population, whereas those of stages II, III, and IV colon cancer patients after diagnosis were 16.57 ± 0.07, 13.35 ± 0.07, and 4.05 ± 0.05 years, respectively; the corresponding expected-years-of-life-lost were 1.28 ± 0.07, 5.93 ± 0.07 and 16.42 ± 0.06 years, significantly shorter than the general population after accounting for lead time bias. Besides, the lifetime cost of managing stage II colon cancer patients would be US $8,416 ± 1939, 14,334 ± 1,755, and 21,837 ± 1,698, respectively, indicating a big saving for early diagnosis and treatment after stratification for age and sex.

Conclusions: Treating colon cancer at younger age and earlier stage saves more life-years and healthcare costs. Future studies are indicated to apply these quantitative results into the cost-effectiveness evaluation of screening program for colon cancers.

No MeSH data available.


Related in: MedlinePlus

Average expected years of life lost (EYLL) of colon cancer patients by different stages.The differences of LE between colon cancer patients and the sex- and age-matched referents were represented in the shadowed area.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4514792&req=5

pone.0133755.g003: Average expected years of life lost (EYLL) of colon cancer patients by different stages.The differences of LE between colon cancer patients and the sex- and age-matched referents were represented in the shadowed area.

Mentions: In Taiwan, five-year survival rates of stageⅠto IV after colon cancer diagnosis were 87.79%, 76.79%, 62.24% and 14.17%, respectively, while those of ten-year rates were 66.80%, 63.23%, 47.11% and 10%, respectively (S1 Fig). Our result indicated that, for colon cancer patients, treatment outcomes in Taiwan were comparable to those of the western countries. Concerning survival extrapolation, the corresponding LE’s of stage II, III and IV colon cancer patients were 16.57, 13.35 and 4.05 years; those of EYLL’s were 1.28, 5.93 and 16.42 years, respectively (Table 2 and Fig 3). For stages II~IV, the differences of LE between different stages and different ages or gender groups were all statistically significant (Tables 2 and 3). The point that logit of W(t) started to approach zero, meaning that colon cancer patients started to have no inferior survival than the sex- and gender-matched general population, started at 65, 71, and 82 months respectively after the initial diagnosis for stage II, III and IV colon cancer patients (data not shown). In general, the younger the age of diagnosis and/or the earlier the stage, the higher the LE and EYLL, which were simultaneously, accompanied with lower lifetime expenditures. Female patients had higher EYLL’s, probably because female residents in Taiwan have a longer LE than that of the male residents.


Estimation of Life-Year Loss and Lifetime Costs for Different Stages of Colon Adenocarcinoma in Taiwan.

Chen PC, Lee JC, Wang JD - PLoS ONE (2015)

Average expected years of life lost (EYLL) of colon cancer patients by different stages.The differences of LE between colon cancer patients and the sex- and age-matched referents were represented in the shadowed area.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4514792&req=5

pone.0133755.g003: Average expected years of life lost (EYLL) of colon cancer patients by different stages.The differences of LE between colon cancer patients and the sex- and age-matched referents were represented in the shadowed area.
Mentions: In Taiwan, five-year survival rates of stageⅠto IV after colon cancer diagnosis were 87.79%, 76.79%, 62.24% and 14.17%, respectively, while those of ten-year rates were 66.80%, 63.23%, 47.11% and 10%, respectively (S1 Fig). Our result indicated that, for colon cancer patients, treatment outcomes in Taiwan were comparable to those of the western countries. Concerning survival extrapolation, the corresponding LE’s of stage II, III and IV colon cancer patients were 16.57, 13.35 and 4.05 years; those of EYLL’s were 1.28, 5.93 and 16.42 years, respectively (Table 2 and Fig 3). For stages II~IV, the differences of LE between different stages and different ages or gender groups were all statistically significant (Tables 2 and 3). The point that logit of W(t) started to approach zero, meaning that colon cancer patients started to have no inferior survival than the sex- and gender-matched general population, started at 65, 71, and 82 months respectively after the initial diagnosis for stage II, III and IV colon cancer patients (data not shown). In general, the younger the age of diagnosis and/or the earlier the stage, the higher the LE and EYLL, which were simultaneously, accompanied with lower lifetime expenditures. Female patients had higher EYLL’s, probably because female residents in Taiwan have a longer LE than that of the male residents.

Bottom Line: All patients were followed-up until the end of 2011.Life-expectancy, expected-years-of-life-lost and lifetime costs were estimated, using a semi-parametric survival extrapolation method and borrowing information from life tables of vital statistics.Besides, the lifetime cost of managing stage II colon cancer patients would be US $8,416 ± 1939, 14,334 ± 1,755, and 21,837 ± 1,698, respectively, indicating a big saving for early diagnosis and treatment after stratification for age and sex.

View Article: PubMed Central - PubMed

Affiliation: Division of Colorectal Surgery and General Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

ABSTRACT

Backgrounds and aims: Life-expectancy of colon cancer patients cannot be accurately answered due to the lack of both large datasets and long-term follow-ups, which impedes accurate estimation of lifetime cost to treat colon cancer patients. In this study, we applied a method to estimate life-expectancy of colon cancer patients in Taiwan and calculate the lifetime costs by different stages and age groups.

Methods: A total of 17,526 cases with pathologically verified colon adenocarcinoma between 2002 and 2009 were extracted from Taiwan Cancer Registry database for analysis. All patients were followed-up until the end of 2011. Life-expectancy, expected-years-of-life-lost and lifetime costs were estimated, using a semi-parametric survival extrapolation method and borrowing information from life tables of vital statistics.

Results: Patients with more advanced stages of colon cancer were generally younger and less co-morbid with major chronic diseases than those with stages I and II. The LE of stage I was not significantly different from that of the age- and sex-matched general population, whereas those of stages II, III, and IV colon cancer patients after diagnosis were 16.57 ± 0.07, 13.35 ± 0.07, and 4.05 ± 0.05 years, respectively; the corresponding expected-years-of-life-lost were 1.28 ± 0.07, 5.93 ± 0.07 and 16.42 ± 0.06 years, significantly shorter than the general population after accounting for lead time bias. Besides, the lifetime cost of managing stage II colon cancer patients would be US $8,416 ± 1939, 14,334 ± 1,755, and 21,837 ± 1,698, respectively, indicating a big saving for early diagnosis and treatment after stratification for age and sex.

Conclusions: Treating colon cancer at younger age and earlier stage saves more life-years and healthcare costs. Future studies are indicated to apply these quantitative results into the cost-effectiveness evaluation of screening program for colon cancers.

No MeSH data available.


Related in: MedlinePlus