Abstract
Background: Several studies suggest that test characteristics for the fecal immunochemical test (FIT) differ by gender, triggering a debate on whether men and women should be screened differently. We used the microsimulation model MISCAN-Colon to evaluate whether screening stratified by gender is cost-effective.Methods: We estimated gender-specific FIT characteristics based on first-round positivity and detection rates observed in a FIT screening pilot (CORERO-1). Subsequently, we used the model to estimate harms, benefits, and costs of 480 gender-specific FIT screening strategies and compared them with uniform screening.Results: Biennial FIT screening from ages 50 to 75 was less effective in women than men [35.7 vs. 49.0 quality-adjusted life years (QALY) gained, respectively] at higher costs (€42,161 vs. -€5,471, respectively). However, the incremental QALYs gained and costs of annual screening compared with biennial screening were more similar for both genders (8.7 QALYs gained and €26,394 for women vs. 6.7 QALYs gained and €20,863 for men). Considering all evaluated screening strategies, optimal gender-based screening yielded at most 7% more QALYs gained than optimal uniform screening and even resulted in equal costs and QA...Continue Reading
References
May 1, 1979·Cancer·R R RickertJ M Frasca
Nov 1, 1992·Gut·J R JassE M Robinson
Sep 1, 1989·Scandinavian Journal of Gastroenterology·L G JohannsenN O Jacobsen
Apr 1, 1988·Cancer·J A Bombi
Aug 15, 1985·International Journal of Cancer. Journal International Du Cancer·J C ClarkJ G Simpson
Feb 15, 1982·Cancer·M H Vatn, H Stalsberg
Oct 1, 1982·Gut·A R WilliamsD W Day
Mar 6, 1999·Computers and Biomedical Research, an International Journal·F LoeveJ D Habbema
Jan 7, 1997·PharmacoEconomics·J E SiegelM R Gold
Jun 11, 1999·The American Journal of Gastroenterology·R M NessR Dittus
Feb 1, 1963·Annals of Surgery·I CHAPMAN
Jan 6, 2006·The American Journal of Gastroenterology·David Lieberman
May 1, 2008·Journal of the National Cancer Institute·K Robin YabroffMartin L Brown
Mar 17, 2009·Cancer·Iris Lansdorp-VogelaarJ Dik F Habbema
Apr 2, 2009·British Journal of Cancer·L HolM E van Leerdam
Apr 16, 2009·British Journal of Cancer·I M C M de KokM van Ballegooijen
May 27, 2009·Gastrointestinal Endoscopy·Iris Lansdorp-VogelaarJ Dik F Habbema
Aug 13, 2009·Gut·L HolE J Kuipers
Sep 26, 2009·Journal of the National Cancer Institute·Iris Lansdorp-VogelaarErnst J Kuipers
May 1, 2010·Lancet·Wendy S AtkinUNKNOWN UK Flexible Sigmoidoscopy Trial Investigators
Aug 12, 2010·The American Journal of Gastroenterology·Hermann BrennerSabrina Hundt
Sep 14, 2010·Best Practice & Research. Clinical Gastroenterology·Jaroslaw Regula, Michal F Kaminski
Feb 8, 2011·CA: a Cancer Journal for Clinicians·Ahmedin JemalDavid Forman
Jun 3, 2011·Epidemiologic Reviews·Iris Lansdorp-VogelaarHermann Brenner
Sep 21, 2011·Gut·R J C SteeleC G Fraser
Nov 18, 2011·The Lancet Oncology·Esther M StoopEvelien Dekker
May 8, 2013·International Journal of Cancer. Journal International Du Cancer·Inge StegemanPatrick M Bossuyt
Apr 1, 2014·Journal of the National Cancer Institute·Samir GuptaMaria Elena Martinez
Oct 9, 2014·Gastrointestinal Endoscopy·Martin C S WongJoseph J Y Sung
Feb 11, 2015·Vaccine·R DonkenM J Knol
Mar 1, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Atija KapidzicErnst J Kuipers
Jun 5, 2015·Gut·Eline H SchreudersErnst J Kuipers
Citations
Sep 16, 2020·Journal of Internal Medicine·R Hultcrantz
Jul 17, 2018·Public Health Reviews·Nicolas Iragorri, Eldon Spackman
Feb 4, 2021·Cancer Reports·Chloe ThomasJuliet A Usher-Smith
Jun 10, 2021·Journal of Medical Screening·Hanna Ribbing WilénJohannes Blom
Aug 31, 2021·International Journal of Cancer. Journal International Du Cancer·Iris Lansdorp-VogelaarCarlo Senore
Oct 13, 2021·Medical Decision Making : an International Journal of the Society for Medical Decision Making·James F O'Mahony