Cost-effective follow-up of the cancer patient. Time for a new look.

Physicians are increasingly aware of their complex responsibilities in finding the difficult compromise necessary to achieve cost-effective follow-up care of cancer patients. They must consider not only the best interests of their patients but also the interests of a cost-conscious society. To meet their new societal obligations, physicians trained solely to serve the patient's best interest must now learn how to do so at the least expense. This implies knowing both the costs and the performance characteristics of the diagnostic tests ordered in follow-up. The authors analyze this dilemma as it applies to follow-up of patients following primary treatment for colon cancer or nonseminomatous testicular cancer. Principles of cost-effective patient management are reviewed.