The comparative cost-effectiveness of colorectal cancer screening using faecal immunochemical test vs. colonoscopy

Faecal immunochemical tests (FITs) and colonoscopy are two common screening tools for colorectal cancer(CRC). Most cost-effectiveness studies focused on survival as the outcome, and were based on modeling techniques instead of real world observational data. This study evaluated the cost-effectivenes...

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Autores principales: Wong, Martin CS, Ching, Jessica YL, Chan, Victor CW, Sung, Joseph JY
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4559662/
https://www.ncbi.nlm.nih.gov/pubmed/26338314
http://dx.doi.org/10.1038/srep13568
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author Wong, Martin CS
Ching, Jessica YL
Chan, Victor CW
Sung, Joseph JY
author_facet Wong, Martin CS
Ching, Jessica YL
Chan, Victor CW
Sung, Joseph JY
author_sort Wong, Martin CS
collection PubMed
description Faecal immunochemical tests (FITs) and colonoscopy are two common screening tools for colorectal cancer(CRC). Most cost-effectiveness studies focused on survival as the outcome, and were based on modeling techniques instead of real world observational data. This study evaluated the cost-effectiveness of these two tests to detect colorectal neoplastic lesions based on data from a 5-year community screening service. The incremental cost-effectiveness ratio (ICER) was assessed based on the detection rates of neoplastic lesions, and costs including screening compliance, polypectomy, colonoscopy complications, and staging of CRC detected. A total of 5,863 patients received yearly FIT and 4,869 received colonoscopy. Compared with FIT, colonoscopy detected notably more adenomas (23.6% vs. 1.6%) and advanced lesions or cancer (4.2% vs. 1.2%). Using FIT as control, the ICER of screening colonoscopy in detecting adenoma, advanced adenoma, CRC and a composite endpoint of either advanced adenoma or stage I CRC was US$3,489, US$27,962, US$922,762 and US$23,981 respectively. The respective ICER was US$3,597, US$439,513, -US$2,765,876 and US$32,297 among lower-risk subjects; whilst the corresponding figure was US$3,153, US$14,852, US$184,162 and US$13,919 among higher-risk subjects. When compared to FIT, colonoscopy is considered cost-effective for screening adenoma, advanced neoplasia, and a composite endpoint of advanced neoplasia or stage I CRC.
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spelling pubmed-45596622015-09-11 The comparative cost-effectiveness of colorectal cancer screening using faecal immunochemical test vs. colonoscopy Wong, Martin CS Ching, Jessica YL Chan, Victor CW Sung, Joseph JY Sci Rep Article Faecal immunochemical tests (FITs) and colonoscopy are two common screening tools for colorectal cancer(CRC). Most cost-effectiveness studies focused on survival as the outcome, and were based on modeling techniques instead of real world observational data. This study evaluated the cost-effectiveness of these two tests to detect colorectal neoplastic lesions based on data from a 5-year community screening service. The incremental cost-effectiveness ratio (ICER) was assessed based on the detection rates of neoplastic lesions, and costs including screening compliance, polypectomy, colonoscopy complications, and staging of CRC detected. A total of 5,863 patients received yearly FIT and 4,869 received colonoscopy. Compared with FIT, colonoscopy detected notably more adenomas (23.6% vs. 1.6%) and advanced lesions or cancer (4.2% vs. 1.2%). Using FIT as control, the ICER of screening colonoscopy in detecting adenoma, advanced adenoma, CRC and a composite endpoint of either advanced adenoma or stage I CRC was US$3,489, US$27,962, US$922,762 and US$23,981 respectively. The respective ICER was US$3,597, US$439,513, -US$2,765,876 and US$32,297 among lower-risk subjects; whilst the corresponding figure was US$3,153, US$14,852, US$184,162 and US$13,919 among higher-risk subjects. When compared to FIT, colonoscopy is considered cost-effective for screening adenoma, advanced neoplasia, and a composite endpoint of advanced neoplasia or stage I CRC. Nature Publishing Group 2015-09-04 /pmc/articles/PMC4559662/ /pubmed/26338314 http://dx.doi.org/10.1038/srep13568 Text en Copyright © 2015, Macmillan Publishers Limited http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Article
Wong, Martin CS
Ching, Jessica YL
Chan, Victor CW
Sung, Joseph JY
The comparative cost-effectiveness of colorectal cancer screening using faecal immunochemical test vs. colonoscopy
title The comparative cost-effectiveness of colorectal cancer screening using faecal immunochemical test vs. colonoscopy
title_full The comparative cost-effectiveness of colorectal cancer screening using faecal immunochemical test vs. colonoscopy
title_fullStr The comparative cost-effectiveness of colorectal cancer screening using faecal immunochemical test vs. colonoscopy
title_full_unstemmed The comparative cost-effectiveness of colorectal cancer screening using faecal immunochemical test vs. colonoscopy
title_short The comparative cost-effectiveness of colorectal cancer screening using faecal immunochemical test vs. colonoscopy
title_sort comparative cost-effectiveness of colorectal cancer screening using faecal immunochemical test vs. colonoscopy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4559662/
https://www.ncbi.nlm.nih.gov/pubmed/26338314
http://dx.doi.org/10.1038/srep13568
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