Abstract
Improvements in translational research have led to improved survival in patients with both localized and metastatic colorectal cancer. However, these benefits come at high costs, and the introduction of six new agents since 1996 for colorectal cancer has resulted in much higher treatment related costs. Even insured patients may face very high treatment related costs through deductibles and co-payments. In addition, since colorectal cancer is a disease of the elderly, many patients may also be facing high treatment related costs for their other medical problems. Physicians should be aware of how these high costs may influence patients' treatment choices and adherence with therapy. This information may be important in counseling patients about the risks and benefits of systemic therapy. These challenges are not limited to patients with colorectal cancer, and physicians who take care of cancer patients across all disease sites will need to confront this increasingly complex issue.