Colonoscopy: Who Gets Treated Where and How Effective is that Treatment?

Stool Test Called Most Cost-Effective Colon Cancer Screen from MedPage Today

Fecal immunochemical testing every year came out on top in a cost-effectiveness analysis of the major colorectal cancer screening tests in average-risk North Americans, researchers said.

A computer model using published cost and efficacy data for eight different screening approaches indicated that fecal immunochemical testing, or FIT, conducted annually would lead to the fewest cancer cases and deaths and with the lowest cost, according to Braden J. Manns, of the University of Calgary in Alberta, and colleagues.

In a hypothetical cohort of 100,000 average-risk individuals, 1,393 screened with FIT would eventually be diagnosed with colorectal cancer and 457 would die, given mid-range assumptions about cost and efficacy, at a cost of $1,797 per person diagnosed, they reported online in Public Library of Science Medicine.

The same cohort would develop 1,796 to 4,857 colorectal cancers if screened with other modalities -- including fecal occult blood testing, colonoscopy, flexible sigmoidoscopy, CT colonography, two types of fecal DNA testing, and no screening -- and 593 to 1,782 deaths would result, Manns and colleagues determined.

Costs of screening and management would average from $1,864 to $2,667 per person with the other strategies.
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