OBJECTIVE: Ovarian cancer accounts for 50% of deaths from gynecologic malignancies. We sought to determine the cost of common methods of surveillance of women with ovarian cancer in first clinical remission. The current standard for post treatment surveillance is the National Comprehensive Cancer Network (NCCN) guidelines. METHODS: We retrospectively determined how recurrence was initially detected at our institution and a cost model was created and applied to the United States population to calculate surveillance costs using the Surveillance Epidemiology & End Results (SEER) database. RESULTS: 57% (n=60) of first recurrences were identified by increasing CA 125 level. Routine office visit identified 27% (n=29) of recurrences, and 15% (n=16) were diagnosed initially with CT scan. In 5% (5/105), CT abnormality was the only finding. 95% (100/105) of patients had either elevated CA 125 or office visit findings at time of recurrence. Of the 22,000 women diagnosed with ovarian cancer yearly, 60% (n=13,266) will have advanced disease and are likely to recur. The surveillance cost for this population for 2 years using our model is $32,500,000 using NCCN guidelines and $58,000,000 if one CT scan is obtained. CONCLUSIONS: Our data suggests that following NCCN guidelines will detect 95% of recurrences. An additional $26 million will be needed to identify the 5% of women with recurrence seen on CT only. Post treatment surveillance of ovarian cancer patients contributes significantly to health care costs. Use of CT scan to follow these patients largely increases cost with only a small increase in recurrence detection.
OBJECTIVE:Ovarian cancer accounts for 50% of deaths from gynecologic malignancies. We sought to determine the cost of common methods of surveillance of women with ovarian cancer in first clinical remission. The current standard for post treatment surveillance is the National Comprehensive Cancer Network (NCCN) guidelines. METHODS: We retrospectively determined how recurrence was initially detected at our institution and a cost model was created and applied to the United States population to calculate surveillance costs using the Surveillance Epidemiology & End Results (SEER) database. RESULTS: 57% (n=60) of first recurrences were identified by increasing CA 125 level. Routine office visit identified 27% (n=29) of recurrences, and 15% (n=16) were diagnosed initially with CT scan. In 5% (5/105), CT abnormality was the only finding. 95% (100/105) of patients had either elevated CA 125 or office visit findings at time of recurrence. Of the 22,000 women diagnosed with ovarian cancer yearly, 60% (n=13,266) will have advanced disease and are likely to recur. The surveillance cost for this population for 2 years using our model is $32,500,000 using NCCN guidelines and $58,000,000 if one CT scan is obtained. CONCLUSIONS: Our data suggests that following NCCN guidelines will detect 95% of recurrences. An additional $26 million will be needed to identify the 5% of women with recurrence seen on CT only. Post treatment surveillance of ovarian cancerpatients contributes significantly to health care costs. Use of CT scan to follow these patients largely increases cost with only a small increase in recurrence detection.
Authors: Melissa K Accordino; Jason D Wright; Sowmya Vasan; Alfred I Neugut; Ana Tergas; Jim C Hu; Dawn L Hershman; Melissa K Accordino; Jason D Wright; Sowmya Vasan; Alfred I Neugut; Ana Tergas; Jim C Hu; Dawn L Hershman Journal: J Oncol Pract Date: 2015-09-15 Impact factor: 3.840
Authors: Emil Lou; Rachel I Vogel; Deanna Teoh; Spencer Hoostal; Aaron Grad; Matthew Gerber; Minnu Monu; Tomasz Lukaszewski; Jaai Deshpande; Michael A Linden; Melissa A Geller Journal: Lab Med Date: 2018-03-21
Authors: Sarah M Temkin; Matthew P Smeltzer; Monique D Dawkins; Leigh M Boehmer; Leigha Senter; Destin R Black; Stephanie V Blank; Anna Yemelyanova; Anthony M Magliocco; Mollie A Finkel; Tracy E Moore; Premal H Thaker Journal: Cancer Date: 2021-11-17 Impact factor: 6.921
Authors: Katharine M Esselen; Angel M Cronin; Kristin Bixel; Michael A Bookman; Robert A Burger; David E Cohn; Mihaela Cristea; Jennifer J Griggs; Charles F Levenback; Gina Mantia-Smaldone; Larissa A Meyer; Ursula A Matulonis; Joyce C Niland; Charlotte Sun; David M O'Malley; Alexi A Wright Journal: JAMA Oncol Date: 2016-11-01 Impact factor: 31.777