Efficacy, effectiveness and cost-effectiveness of endoscopic screening methods.
Epidemiological evidence suggests that incidence of colorectal cancer can be reduced by 60-90% among participants of preventive colonoscopy with removal of precancerous lesions. Even with sigmoidoscopy, the majority of cancers can be prevented. Cost-effectiveness analyses suggest screening schemes based on colonoscopy every 10 years or on sigmoidoscopy every 5 years to be highly cost effective compared to other preventive measures. Even higher cost-effectiveness is to be expected if screening intervals can be extended to 20 or more years, as suggested by recent epidemiological evidence.
Brenner
H
H
Div. of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. H.Brenner@dkfz.de
D003113:Colonoscopy / Q000191:economics*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D005858:Germany; D008403:Mass Screening / Q000191:economics*; D009780:Occult Blood; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D012812:Sigmoidoscopy / Q000191:economics*; D016019:Survival Analysis