title: Comparisons of cancer detection rate and costs of one cancer detected among different age-cohorts in immunochemical occult blood screening.
abstract: OBJECTIVE
  This study was carried out to compare the detection rate for colorectal cancer and the average costs to detect one patient with colorectal cancer among three different age-cohorts in immunochemical occult blood screening by OC-Hemodia.
  
  
  METHODS
  In a population-screening program, 17,432 subjects received an immunochemical fecal occult blood test. In a medical checkup for colorectal cancer 7,232 subjects received colonoscopy. They were divided into three groups according to their ages: younger (4,049 years); middle (50-59); and older (60+) groups. The detection rate for colorectal cancer and the average costs to detect one patient with colorectal cancer were evaluated among the three groups.
  
  
  RESULTS
  In the screening program-based study, the cancer detection rate and the average costs for one colorectal cancer detected were calculated as 0.09% and $13,352, 0.28% and $4,555, 0.29% and $4,461 for the younger, middle, and older groups, respectively. In addition, in the medical checkup-based study, the detection rate and the average costs were calculated as 0.3% and $6,851, 1.5% and $1,517, 1.7% and $1,391 for the younger, middle, and older groups, respectively. In these two studies, the cancer detection rates were significantly different between the younger and middle groups (P < 0.05), and between the younger and older groups (P < 0.05).
  
  
  CONCLUSIONS
  These findings indicate that the subjects aged under 50 have some disadvantage when carrying out the immunochemical fecal occult blood test--OC-Hemodia for colorectal cancer screening--from the viewpoint of screening efficiency as well as cost-effectiveness.
authors.affiliation: Department of Public Health, Shinshu University School of Medicine, Matsumoto, Japan. hnakama@sch.md.shinshu-u.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Nakama
authors.forename: B
authors.initials: B
authors.lastname: Zhang
authors.forename: K
authors.initials: K
authors.lastname: Fukazawa
authors.forename: X
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D015397:Program Evaluation