The cost-effectiveness of screening for colorectal cancer.

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
Jennifer J TelfordRobert A Enns

Abstract

Published decision analyses show that screening for colorectal cancer is cost-effective. However, because of the number of tests available, the optimal screening strategy in Canada is unknown. We estimated the incremental cost-effectiveness of 10 strategies for colorectal cancer screening, as well as no screening, incorporating quality of life, noncompliance and data on the costs and benefits of chemotherapy. We used a probabilistic Markov model to estimate the costs and quality-adjusted life expectancy of 50-year-old average-risk Canadians without screening and with screening by each test. We populated the model with data from the published literature. We calculated costs from the perspective of a third-party payer, with inflation to 2007 Canadian dollars. Of the 10 strategies considered, we focused on three tests currently being used for population screening in some Canadian provinces: low-sensitivity guaiac fecal occult blood test, performed annually; fecal immunochemical test, performed annually; and colonoscopy, performed every 10 years. These strategies reduced the incidence of colorectal cancer by 44%, 65% and 81%, and mortality by 55%, 74% and 83%, respectively, compared with no screening. These strategies generated inc...Continue Reading

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Citations

Sep 26, 2012·International Journal of Technology Assessment in Health Care·Paul HanlyLinda Sharp
Aug 18, 2010·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Robert A Smith
Jun 15, 2011·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Maida J Sewitch, A N Barkun
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