Medical expenditures for colorectal cancer diagnosis and treatment: A 10-year high-level-hospital-based multicenter retrospective survey in China, 2002 - 2011

Jufang Shi; Guoxiang Liu; Hong Wang; Ayan Mao; Chengcheng Liu; Lanwei Guo; Huiyao Huang; Jiansong Ren; Xianzhen Liao; Yana Bai; Xiaojie Sun; Xinyu Zhu; Jialin Wang; Bingbing Song; Jinyi Zhou; Lin Zhu; Haike Lei; Yuqin Liu; Yunyong Liu; Lingbin Du; Yutong He; Kai Zhang; Ni Li; Wanqing Chen; Min Dai; Jie He

doi:10.21147/j.issn.1000-9604.2019.05.12

Medical expenditures for colorectal cancer diagnosis and treatment: A 10-year high-level-hospital-based multicenter retrospective survey in China, 2002 - 2011

Chin J Cancer Res. 2019 Oct;31(5):825-837. doi: 10.21147/j.issn.1000-9604.2019.05.12.

Authors

Jufang Shi¹, Guoxiang Liu², Hong Wang¹, Ayan Mao³, Chengcheng Liu¹, Lanwei Guo^{4

1}, Huiyao Huang¹, Jiansong Ren¹, Xianzhen Liao⁵, Yana Bai⁶, Xiaojie Sun⁷, Xinyu Zhu^{1

6}, Jialin Wang⁸, Bingbing Song⁹, Jinyi Zhou¹⁰, Lin Zhu¹¹, Haike Lei¹², Yuqin Liu¹³, Yunyong Liu¹⁴, Lingbin Du¹⁵, Yutong He¹⁶, Kai Zhang¹, Ni Li¹, Wanqing Chen¹, Min Dai¹, Jie He¹⁷

Affiliations

¹ Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
² Department of Health Economics, School of Health Management/Public Health, Harbin Medical University, Harbin 150081, China.
³ Office of Public Health Strategic Information, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China.
⁴ Department of Cancer Epidemiology, Henan Office for Cancer Control and Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China.
⁵ Hunan Office for Cancer Control and Research, Hunan Provincial Cancer Hospital, Changsha 410006, China.
⁶ Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou 730000, China.
⁷ Center for Health Management and Policy, Key Lab of Health Economics and Policy, Shandong University, Jinan 250012, China.
⁸ Department of Public Health, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, China.
⁹ Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China.
¹⁰ Institute of Chronic Non-communicable Diseases Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
¹¹ Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China.
¹² Department of Cancer Research and Control Office, Chongqing University Cancer Hospital, Chongqing 400030, China.
¹³ Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou 730050, China.
¹⁴ Cancer Prevention and Control Office of Liaoning Province, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang 110042, China.
¹⁵ Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou 310022, China.
¹⁶ Cancer Institute, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, China.
¹⁷ Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

PMID: 31814686
PMCID: PMC6856700
DOI: 10.21147/j.issn.1000-9604.2019.05.12

Abstract

Objective: Colorectal cancer (CRC) causes a substantial burden of disease in China and the evidence of economic burden triggered is fundamental for priority setting. The aim of this survey was to quantify medical expenditures and the time trends for CRC diagnosis and treatment in China.

Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 13 provinces across China. For each eligible CRC patient diagnosed from 2002 to 2011, clinical information and expenditure data were extracted using a uniform questionnaire. All expenditure data were reported in Chinese Yuan (CNY) using 2011 values.

Results: Of the 14,536 CRC patients included, the average age at diagnosis was 58.2 years and 15.8% were stage-I cases. The average medical expenditure per patient was estimated at 37,902 CNY [95 % confidence interval (95% CI): 37,282-38,522], and the annual average increase rate was 9.2% from 2002 to 2011 (P for trend <0.001), with a cumulative increase of 2.4 times (from 23,275 CNY to 56,010 CNY). The expenditure per patient in stages I, II, III and IV were 31,698 CNY, 37,067 CNY, 38,918 CNY and 42,614 CNY, respectively (P<0.001). Expenditure significantly differed within various subgroups. Expenses for drugs contributed the largest proportion (52.6%).

Conclusions: These conservative estimates illustrated that medical expenditures for CRC diagnosis and treatment in tertiary hospitals in China were substantial and increased rapidly over the 10 years, with drugs continually being the main expense by 2011. Relatively, medical expenditures are lower for CRC in the earlier stages. These findings will facilitate the economic evaluation of CRC prevention and control in China.

Keywords: China; Colorectal neoplasms; diagnosis; health expenditures; therapeutics.