title: Costs of flexible sigmoidoscopy screening for colorectal cancer in the United Kingdom.
abstract: OBJECTIVE
  Colorectal cancer is one of the most commonly occurring cancers in industrialized countries, yet appears to be amenable to screening. Amongst the many possible protocols is once-only screening by means of flexible sigmoidoscopy. This protocol is currently being investigated in a UK multicenter trial and the study provides estimates of the expected resource costs.
  
  
  METHODS
  The direct health care costs of sigmoidoscopy and of all subsequent procedures were estimated from an audit of resource use of approximately 40,000 patients at thirteen centers. Patient-borne costs were estimated from the results of surveys conducted at twelve of these centers.
  
  
  RESULTS
  The health service costs of a flexible sigmoidoscopy was estimated at pounds 56. The total costs of screening (including private costs) averaged pounds 82 per person screened, although costs varied by center. The total health service costs of screening and subsequent management averaged approximately pounds 91 per person screened, again with variations between centers.
  
  
  CONCLUSIONS
  Even within a strict trial protocol, intercenter variation in costs can be detected, ascribable to variability in local management practices, local yield, and local patient-borne costs. Other recent estimates of flexible sigmoidoscopy costs vary widely. As these costs form the basis of technology assessment simulation models which, in turn, inform policy obtaining realistic cost estimates within the appropriate health care setting is of paramount importance.
authors.affiliation: School of Economics, University of Nottingham, UK. david.whynes@nottingham.ac.uk
authors.forename: David K
authors.initials: DK
authors.lastname: Whynes
authors.forename: Emma J
authors.initials: EJ
authors.lastname: Frew
authors.forename: Robert
authors.initials: R
authors.lastname: Edwards
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Atkin
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003365:Costs and Cost Analysis; D005382:Financing, Personal; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D012812:Sigmoidoscopy / Q000191:economics*; D013222:State Medicine / Q000191:economics; D013673:Technology Assessment, Biomedical / Q000191:economics*; D006113:United Kingdom