title: Costs of colorectal cancer screening provision in CDC's Colorectal Cancer Control Program: Comparisons of colonoscopy and FOBT/FIT based screening.
abstract: We assess annual costs of screening provision activities implemented by 23 of the Centers for Disease Control and Prevention's Colorectal Cancer Control Program (CRCCP) grantees and report differences in costs between colonoscopy and FOBT/FIT-based screening programs. We analysed annual cost data for the first three years of the CRCCP (July 2009-June 2011) for each screening provision activity and categorized them into clinical and non-clinical screening provision activities. The largest cost components for both colonoscopy and FOBT/FIT-based programs were screening and diagnostic services, program management, and data collection and tracking. During the first 3 years of the CRCCP, the average annual clinical cost for screening and diagnostic services per person served was $1150 for colonoscopy programs, compared to $304 for FIT/FOBT-based programs. Overall, FOBT/FIT-based programs appear to have slightly higher non-clinical costs per person served (average $1018; median $838) than colonoscopy programs (average $980; median $686). Colonoscopy-based CRCCP programs have higher clinical costs than FOBT/FIT-based programs during the 3-year study timeframe (translating into fewer people screened). Non-clinical costs for both approaches are similar and substantial. Future studies of the cost-effectiveness of colorectal cancer screening initiatives should consider both clinical and non-clinical costs.
authors.affiliation: RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452, USA. Electronic address: ssubramanian@rti.org.
authors.forename: Sujha
authors.initials: S
authors.lastname: Subramanian
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA.
authors.forename: Florence K L
authors.initials: FKL
authors.lastname: Tangka
authors.affiliation: RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452, USA.
authors.forename: Sonja
authors.initials: S
authors.lastname: Hoover
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Royalty
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: DeGroff
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA.
authors.forename: Djenaba
authors.initials: D
authors.lastname: Joseph
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D003113:Colonoscopy / Q000191:economics; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods*; D006801:Humans; D009780:Occult Blood; D015397:Program Evaluation / Q000379:methods*; D014481:United States
keywords: Activity-based costing; Colorectal cancer screening; Economic evaluation; Screening cost