Cost-benefit analysis of screening colonoscopy in 40- to 50-year-old first-degree relatives of patients with colorectal cancer.
OBJECTIVE
As shown previously, 40- to 50-year-old first-degree relatives of patients with colorectal cancer (CRC) have significantly more colorectal adenomas than controls of the same age. Screening colonoscopy of these persons at risk between 40 and 50 years might be cost beneficial.


METHODS
We prepared a detailed cost-benefit analysis of screening colonoscopy and possible repeat endoscopies according to current expenditures for endoscopic procedures in Germany. Since screening colonoscopy is generally offered and reimbursed from 55 years on in Germany, we analysed the period between 45 and 55 years, taking an annual interest rate of 5% into account. Costs were analysed based on the results of a former study [11] depending on various participation rates in a general screening programme.


RESULTS
Based on the available 1994 figure of about 20,000 euros for diagnosis and treatment of one cancer case, screening colonoscopy is cost beneficial when participation is high. Under a more realistic assumption of currently about 40,000 euros per cancer case, screening colonoscopy is cost beneficial in any case.


CONCLUSIONS
Our data support that systematic screening colonoscopy in first-degree relatives of patients with CRC by the age of 45 years most likely demonstrates an economic benefit.
Menges
Markus
M
Department of Internal Medicine II, Division of Gastroenterology, University of the Saarland, Homburg, Germany. Markus.Menges@diaksha.de
Gärtner
Barbara
B
Georg
Thomas
T
Fischinger
Johannes
J
Zeitz
Martin
M
D000328:Adult; D003113:Colonoscopy / Q000191:economics*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000191:economics / Q000235:genetics; D003362:Cost-Benefit Analysis; D020022:Genetic Predisposition to Disease; D005858:Germany; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D010375:Pedigree; D011379:Prognosis