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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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group
2015
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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. |
format | Online Article Text |
id | pubmed-4559662 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
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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