title: Clinical costs of colorectal cancer screening in 5 federally funded demonstration programs.
abstract: BACKGROUND
  The Centers for Disease Control and Prevention initiated the Colorectal Cancer Screening Demonstration Program (CRCSDP) to explore the feasibility of establishing a large-scale colorectal cancer (CRC) screening program for underserved populations in the United States. The authors of this report assessed the clinical costs incurred at each of the 5 participating sites during the demonstration period.
  
  
  METHODS
  By using data on payments to providers by each of the 5 CRCSDP sites, the authors estimated costs for specific clinical services and overall clinical costs for each of the 2 CRC screening methods used by the sites: colonoscopy and fecal occult blood test (FOBT).
  
  
  RESULTS
  Among CRCSDP clients who were at average risk for CRC and for whom complete cost data were available, 2131 were screened by FOBT, and 1888 were screened by colonoscopy. The total average clinical cost per individual screened by FOBT (including costs for screening, diagnosis, initial surveillance, office visits, and associated clinical services averaged across all individuals who received screening FOBT) ranged from $48 in Nebraska to $149 in Greater Seattle. This compared with an average clinical cost per individual for all services related to the colonoscopy screening ranging from $654 in St. Louis to $1600 in Baltimore City.
  
  
  CONCLUSIONS
  Variations in how sites contracted with providers and in the services provided through CRCSDP affected the cost of clinical services and the complexity of collecting cost data. Health officials may find these data useful in program planning and budgeting.
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA. ftangka@cdc.gov
authors.forename: Florence K L
authors.initials: FK
authors.lastname: Tangka
authors.forename: Sujha
authors.initials: S
authors.lastname: Subramanian
authors.forename: Maggie C
authors.initials: MC
authors.lastname: Beebe
authors.forename: Sonja
authors.initials: S
authors.lastname: Hoover
authors.forename: Janet
authors.initials: J
authors.lastname: Royalty
authors.forename: Laura C
authors.initials: LC
authors.lastname: Seeff
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D003113:Colonoscopy / Q000191:economics; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics* / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods*; D006801:Humans; D009780:Occult Blood; D012307:Risk Factors; D014481:United States
keywords: cancer screening program; clinical cost; colorectal cancer; cost assessment