Cost-effectiveness of colorectal cancer screening - an overview.
There are several modalities available for a colorectal cancer (CRC) screening program. When determining which CRC screening program to implement, the costs of such programs should be considered in comparison to the health benefits they are expected to provide. Cost-effectiveness analysis provides a tool to do this. In this paper we review the evidence on the cost-effectiveness of CRC screening. Published studies universally indicate that when compared with no CRC screening, all screening modalities provide additional years of life at a cost that is deemed acceptable by most industrialized nations. Many recent studies even find CRC screening to be cost-saving. However, when the alternative CRC screening strategies are compared against each other in an incremental cost-effectiveness analysis, no single optimal strategy emerges across the studies. There is consensus that the new technologies of stool DNA testing, computed tomographic colonography and capsule endoscopy are not yet cost-effective compared with the established CRC screening tests.
Lansdorp-Vogelaar
Iris
I
Department of Public Health, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands. i.vogelaar@erasmusmc.nl
Knudsen
Amy B
AB
Brenner
Hermann
H
D053704:Capsule Endoscopy / Q000191:economics; D023881:Colonography, Computed Tomographic / Q000191:economics; D003113:Colonoscopy / Q000191:economics; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000517:prevention & control; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data / Q000639:trends*; D055088:Early Detection of Cancer / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends*; D005243:Feces; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods / Q000639:trends*; D009780:Occult Blood; D019057:Quality-Adjusted Life Years; D012812:Sigmoidoscopy / Q000191:economics