MEDICAL COST ESTIMATION STUDY REGARDING MANAGEMENT OF THE MOST COMMON MALIGNANCIES A MONG EGYPTIAN FEMALES (AGED 18 YEARS OR ABOVE) ATTENDING THE NATIONAL CANCER INSTITUTE, CAIRO UNIVERSITY

Abstract

Considerable attention has been paid to the high cost of cancer care. The main goal of this work was to calculate the direct medical cost of patients suffering from breast cancer (200 cases), cervix uteri cancer (100 cases) and NHL (100 cases) presenting to the NCI, Cairo University. The direct medical costs of these patients were assessed using the patient's medical records from the statistical and epidemiology unit, NCI. In our study, 63% of breast cancer cases 61% of cervix uteri cancer cases and 48% ofNHL cases were 40 to 60 years old. The median age was 45 years for breast; 50 years for NHL and 51 years for cervix uteri cancer. Higher grade cases (grade 2 & 3) represented nearly 99% of breast cancer cases, 93% ofNHL and all cases of cervix uteri cancer. Advanced stages represented about 99% of breast cases, 72% of NHL cases and 73% of cervix uteri cancer cases. Multimodality treatment was applied in 73% of breast

cancer cases, 36% of cancer of the cervix uteri and 31% ofNHL cases. The median total cost of breast cancer cases was 4,151 L.E. while it was 2,740 L.E. for cervix uteri cancer cases and 2,687 L.E. for NHL cases. Costs of investigations represented 12.1% of the total cost of cervix uteri cancer cases, 7.5% in breast cancer cases and 11.7% in NHL cases. Hospital stay cost represented about 25% of the total cost in cases of cervix uteri cancer, 9.3% in breast cancer cases and 3.4% in NHL cases. The cost of surgery accounted for 30.1% of the total cost of breast cancer cases, 6.3% in NHL cases, and 25.1% in cervix uteri cancer cases. Chemotherapy costs constituted 70.6% in NHL,

41.5% in breast cancer cases, and less than I% in cervix uteri cancer. The median cost of chemotherapy in cases ofNHL was 2,743 L.E., while it was 1,756 L.E. in cases of breast cancer. Radiotherapy represented 29.6% of the total cost of cervix uteri cancer cases, 10.3% of breast cancer, and 7.5% ofNHL cases. The total cost of the whole study group (400 cases) was 1,569,311 L.E. The mean cost was 3,923 L.E. Considering that the study group is representing about 17% of the total number of admitted cases in the NCI, the grand total cost would be 9,231,241.1 L.E. The mean cost was higher for breast cancer cases (4,495 L.E.) in comparison to cervix uteri cancer cases (2,945 L.E.) and NHL cases (3,758 L.E.).