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Objective: There is debate over whether radiation therapy or transoral laser microsurgery (TLM) is the superior treatment for early glottic cancer. Both offer similar cure rates and posttherapy quality of life. One factor that could decide the optimum therapy is cost. Several studies in Europe and the United States show that TLM is the most cost-effective treatment. The goal of this study was to conduct the first cost analysis in Canada on the treatment of early glottic cancer comparing radiation therapy and TLM. Design and Methods: The study was conducted retrospectively. TLM and radiation therapy were broken down into individual components, and then the price for each component was summed. Setting: The study was conducted at the Queen Elizabeth II Health Science Centre in Halifax, Nova Scotia. Main Outcome Measures: The main outcome measure was total cost. Results: It was found that radiation therapy was approximately four times more expensive than TLM. Conclusions: This study suggests that TLM should be the preferred treatment option for treating early glottic cancer in Canada as it is the most economical and has been shown in previous studies to be as effective as radiation therapy in both cure rates and quality of life. [ABSTRACT FROM AUTHOR]