Cost of prostate cancer care varies with initial treatment choice

A new analysis has found that short-term and long-term costs of prostate cancer care vary considerably based on which treatment strategy a man initially receives. Published early on-line in Cancer, a peer-reviewed journal of the American Cancer Society, the study finds that treatments that may be less expensive in the short-term may have higher long-term costs.

For men with early stage prostate cancer, various treatments are available, including surgery, radiation therapy, hormonal treatment, watchful waiting or combinations of the above. A variety of factors determines which treatment is appropriate for a given man and, in some cases, a man may be able to choose among several options. Cost is one of many factors to consider when choosing among these options.

To determine how the initial treatment received by men with early stage prostate cancer affects costs of medical care both in the short-term (first year following diagnosis) and long-term (across five years of follow-up), Claire Snyder of the Johns Hopkins School of Medicine and the Johns Hopkins Bloomberg School of Public Health in Baltimore, USA, led a team that reviewed early stage prostate-cancer cases from the Surveillance, Epidemiology and End Results (SEER)-Medicare database. (This database combines cancer incidence and survival data from US population-based cancer registries with Medicare administrative claims.) Patients included 13,769 men aged 66 years or older who were diagnosed in 2000 and were followed for five years. They were divided into groups based on the treatment they received during the first nine months after diagnosis: watchful waiting, radiation, hormonal therapy, hormonal therapy plus radiation and surgery (men in this latter group may have received hormones and/or radiation as well). Treatment costs were divided into initial (months -1 to 12), long-term (each 12 months thereafter), and total (months -1 to 60) costs. The incremental costs of care were calculated as the difference in medical costs for patients versus a group of similar men without cancer.