title: Cost effectiveness of interventions to promote screening for colorectal cancer: a randomized trial.
abstract: OBJECTIVE
  Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention.
  
  
  METHODS
  A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 participants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping.
  
  
  RESULTS
  The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy.
  
  
  CONCLUSIONS
  The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and cost-effectiveness of interventions to increase colorectal cancer screening.
authors: School of Public Health, University of Texas Health Science Center at Houston, Houston, USA.
authors: Swati
authors: S
authors: Misra
authors: David R
authors: DR
authors: Lairson
authors: Wenyaw
authors: W
authors: Chan
authors: Yu Chia
authors: YC
authors: Chang
authors: L Kay
authors: LK
authors: Bartholomew
authors: Anthony
authors: A
authors: Greisinger
authors: Amy
authors: A
authors: McQueen
authors: Sally W
authors: SW
authors: Vernon
references: Cancer. 2008 Feb 15;112(4):779-88
references: 18098272
references: Addict Behav. 1993 May-Jun;18(3):269-90
references: 8342440
references: Arch Intern Med. 2009 Jan 12;169(1):47-55
references: 19139323
references: J Gen Intern Med. 2009 Nov;24(11):1228-35
references: 19763699
references: Health Psychol. 2008 Mar;27(2):179-84
references: 18377136
references: Health Econ. 1997 Jul-Aug;6(4):327-40
references: 9285227
references: Health Econ. 2003 May;12(5):377-92
references: 12720255
references: CA Cancer J Clin. 2007 Nov-Dec;57(6):354-66
references: 17989130
references: Health Educ Behav. 1998 Oct;25(5):545-63
references: 9768376
references: CA Cancer J Clin. 2001 Jan-Feb;51(1):38-75; quiz 77-80
references: 11577479
references: Med Care. 2010 Jun;48(6):553-7
references: 20473196
references: Clin Ther. 1999 Aug;21(8):1370-9
references: 10485508
references: Health Psychol. 1993 Sep;12(5):399-405
references: 8223364
references: J Am Med Inform Assoc. 2006 Sep-Oct;13(5):476-84
references: 16799126
references: Cancer. 2007 Nov 1;110(9):2083-91
references: 17893869
references: Ann Behav Med. 2011 Jun;41(3):284-99
references: 21271365
references: Health Econ. 2001 Mar;10(2):179-84
references: 11252048
references: Cancer. 2004 Sep 1;101(5 Suppl):1229-38
references: 15316909
references: Arch Intern Med. 2009 Feb 23;169(4):364-71
references: 19237720
references: Health Educ Behav. 2002 Dec;29(6):755-70
references: 12456132
references: CA Cancer J Clin. 2008 May-Jun;58(3):130-60
references: 18322143
references: Patient Educ Couns. 2009 Nov;77(2):155-71
references: 19376676
references: Prev Med. 2004 Aug;39(2):230-8
references: 15226030