title: Costs and benefits of an organized fecal immunochemical test-based colorectal cancer screening program in the United States.
abstract: BACKGROUND
  Despite clear recommendations and evidence linking colorectal cancer screening to lower incidence and mortality, > 40% of adults are not up to date with screening. Existing domestic and international models of organized cancer screening programs have been effective in increasing screening rates. Implementing an organized, evidence-based, national screening program may be an effective approach to increasing screening rates.
  
  
  METHODS
  In the current study, the authors estimated the initial investment required and the cost per person screened of a nationwide fecal immunochemical test (FIT)-based colorectal cancer screening program among adults aged 50 years to 75 years.
  
  
  RESULTS
  The initial additional investment required was estimated at $277.9 to $318.2 million annually, with an estimated 8.7 to 9.4 million individuals screened at a cost of $32 to $39 per person screened. The program was estimated to prevent 2900 to 3100 deaths annually.
  
  
  CONCLUSIONS
  The results of the current study indicate that implementing a national screening program would make a substantial public health impact at a moderate cost per person screened. Results from this analysis may provide useful information for understanding the public health benefit of an organized screening delivery system and the potential resources required to implement a nationwide colorectal cancer screening program, and help guide decisions about program planning, design, and implementation.
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Gery P
authors.initials: GP
authors.lastname: Guy
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Richardson
authors.forename: Michael P
authors.initials: MP
authors.lastname: Pignone
authors.forename: Marcus
authors.initials: M
authors.lastname: Plescia
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics*; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics*; D005260:Female; D006801:Humans; D007120:Immunochemistry; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D014481:United States
keywords: colorectal cancer; early detection; health economics; public health; screening
references.citation: Gastroenterology. 2011 Nov;141(5):1551-5
references.pmid: 21945057
references.citation: J Am Acad Dermatol. 2011 Nov;65(5 Suppl 1):S133-43
references.pmid: 22018062
references.citation: Endoscopy. 2007 Feb;39(2):168-73
references.pmid: 17327977
references.citation: J Natl Cancer Inst. 2009 Oct 21;101(20):1412-22
references.pmid: 19779203
references.citation: Med J Aust. 2011 Feb 21;194(4):180-5
references.pmid: 21401458
references.citation: Cancer. 2011 Sep 15;117(18):4166-74
references.pmid: 21387272
references.citation: Cancer. 2008 Feb 1;112(3):626-35
references.pmid: 18157831
references.citation: Med J Aust. 2013 Apr 1;198(6):327-30
references.pmid: 23545032
references.citation: J Gen Intern Med. 2003 May;18(5):357-63
references.pmid: 12795734
references.citation: Int J Cancer. 2011 May 15;128(10):2415-24
references.pmid: 20658527
references.citation: Int J Cancer. 2008 Mar 15;122(6):1357-67
references.pmid: 18033685
references.citation: Am J Prev Med. 2011 Apr;40(4):397-404
references.pmid: 21406272
references.citation: Epidemiol Rev. 2011;33:101-10
references.pmid: 21709143
references.citation: Gastrointest Endosc Clin N Am. 2010 Oct;20(4):751-70
references.pmid: 20889076
references.citation: Eval Program Plann. 2011 May;34(2):147-53
references.pmid: 21036399
references.citation: J Clin Oncol. 2013 Jun 1;31(16):1928-30
references.pmid: 23589553
references.citation: N Engl J Med. 2006 Nov 2;355(18):1863-72
references.pmid: 17079760
references.citation: Med Care Res Rev. 2003 Sep;60(3):294-331
references.pmid: 12971231
references.citation: N Engl J Med. 2010 Sep 30;363(14):1296-9
references.pmid: 20879876
references.citation: Epidemiol Rev. 2011;33:88-100
references.pmid: 21633092
references.citation: J Med Screen. 2007;14(2):73-5
references.pmid: 17626705
references.citation: Gastroenterology. 2008 Jul;135(1):82-90
references.pmid: 18482589
references.citation: J Natl Cancer Inst. 2011 Jan 19;103(2):117-28
references.pmid: 21228314
references.citation: Am J Prev Med. 2006 Jul;31(1):80-9
references.pmid: 16777546
references.citation: Gastroenterology. 2012 Sep;143(3):844-857
references.pmid: 22763141
references.citation: Prev Med. 2004 Apr;38(4):375-81
references.pmid: 15020170
references.citation: Ann Intern Med. 2006 Dec 19;145(12):880-6
references.pmid: 17179057
references.citation: J Gen Intern Med. 2009 Nov;24(11):1192-7
references.pmid: 19774423
references.citation: Ann Fam Med. 2012 Sep-Oct;10(5):412-7
references.pmid: 22966104
references.citation: MMWR Morb Mortal Wkly Rep. 2012 Jan 27;61(3):41-5
references.pmid: 22278157
references.citation: J Community Health. 2013 Feb;38(1):31-9
references.pmid: 22875234
references.citation: JAMA Intern Med. 2013 Oct 14;173(18):1725-32
references.pmid: 23921906
references.citation: Am J Prev Med. 2012 Jul;43(1):97-118
references.pmid: 22704754
references.citation: N Engl J Med. 2000 Jul 20;343(3):162-8
references.pmid: 10900274