The clinical value and the cost-effectiveness of follow-up in endometrial cancer patients
- 1 September 2004
- journal article
- review article
- Published by BMJ in International Journal of Gynecologic Cancer
- Vol. 14 (5), 931-937
- https://doi.org/10.1111/j.1048-891x.2004.014532.x
Abstract
The aim of the present article was to evaluate the cost-effectiveness of follow-up in endometrial cancer patients. A literature review was performed regarding the studies that addressed routine follow-up of endometrial cancer. For each published study, the costs of the follow-up program were calculated according to Belgium standards. A mean total of 13% relapsed. Symptomatology and clinical examination detected over 83% of the recurrences. The follow-up cost in euro after 5 and 10 years ranged between 127.68 and 2,028.78 and between 207.48 and 2,353.48, respectively. Based on the available data, there is little evidence of routine follow-up improving survival rates. Multiple protocols are used in practice without an evidence base. There is an urgent need for prospective randomized studies to evaluate the value of the current so-called 'standard medical practice of follow-up.' It is to be expected that the cost of follow-up could be reduced considerably, for instance, by tailoring to low- and high-risk groups, or by abandoning routine follow-up. Symptomatic patients, however, should be evaluated immediately. A reduction in the number of visits and examinations would mean an enormous reduction in costs. This economic benefit would be warmly welcomed in the times of increased health costs and decreased budgets.Keywords
This publication has 19 references indexed in Scilit:
- Pulmonary metastasis from endometrial carcinomaInternational Journal of Gynecologic Cancer, 2002
- Value and cost evaluation of routine follow-up for patients with clinical stage I/II endometrial cancerEuropean Journal of Cancer, 2001
- Computed tomography in endometrial carcinomaObstetrics & Gynecology, 2000
- Recurrence of endometrial carcinoma and the value of routine follow upBJOG: An International Journal of Obstetrics and Gynaecology, 1997
- Surveillance for Recurrent Endometrial Carcinoma: Development of a Follow-up SchemeGynecologic Oncology, 1995
- Postsurgical Surveillance of Patients with FIGO Stage I/II Endometrial AdenocarcinomaGynecologic Oncology, 1995
- An Evaluation of Routine Follow-Up of Patients Treated for Endometrial CarcinomaGynecologic Oncology, 1994
- Detection and patterns of treatment failure in 300 consecutive cases of “early” endometrial cancer after primary surgeryGynecologic Oncology, 1992
- CA 125: A useful marker in endometrial carcinomaAmerican Journal of Obstetrics and Gynecology, 1986
- Elevation of serum CA125 in carcinomas of the fallopian tube, endometrium, and endocervixAmerican Journal of Obstetrics and Gynecology, 1984