MedicalResearch.com Interview with:
Caroline Watts| PhD Candidate
Cancer Epidemiology and Services Research | Sydney School of Public Health
The University of Sydney
MedicalResearch: What is the background for this study? What are the main findings?
Response: A clinic for people at high risk of melanoma was established at the Royal Prince Alfred Hospital, Sydney in 2006 to look at the impact of surveillance regime which included regular full body skin examination supported by dermoscopy and total body photography at 6 monthly intervals. If a suspicious lesion was identified, the lesion was either removed or sequential digital dermoscopy was performed and the patient returned in 3 months for review. This study aimed to estimate the costs associated with surveillance in this type of specilaised clinic.
The mean number of clinic visits per year was 2.7 (95% CI, 2.5-2.8) for surveillance and 3.8 (95% CI, 3.4-4.1) for patients requiring surgical excisions. The mean annual cost per patient to the health system was A $882 (95% CI, A $783-$982) (US $599 [95% CI, US $532-$665]) and mean annual societal cost per patient (excluding health system costs) was A $972 (95% CI, A $899-$1045) (US $660 [95% CI, US $611-$710). Diagnosis of melanoma or non-melanoma skin cancer and frequent excisions for benign lesions in a relatively small number of patients was responsible for skewed health system costs.
MedicalResearch: What should clinicians and patients take away from your report?
Response: From a health system perspective, the costs of surveillance are driven by the labour costs of the clinic staff and the number of follow-up extended-length surveillance consultations required by these patients. The cost from a societal perspective are similar to health system costs reflecting the amount of time patients are willing to give up to attend the clinic. High-risk patients in specilaised surveillance programs have been shown to have melanomas detected at an earlier stage compared with high-risk individuals not in a specilaised surveillance program. There is less morbidity and health care costs if melanoma is detected early.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Response: Recommendations for future research include identifying which groups would benefit most from this specialized screening strategy and trialling this type of clinic in other practice settings to reduce the cost of surveillance. Results from this study will be used in an economic evaluation of the cost-effectiveness of this specialised model of care for individuals at high risk for melanoma compared with standard care in the community.
MedicalResearch.com Interview with: Caroline Watts| PhD Candidate (2015). How Much Does Specialized Melanoma Screening Cost? MedicalResearch.com