Amnon Sonnenberg, MD, MSc
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Sonnenberg A.; Cost-Effectiveness of Screening for Colorectal Cancer. Ann Intern Med. 2001;135:219. doi: 10.7326/0003-4819-135-3-200108070-00019
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Published: Ann Intern Med. 2001;135(3):219.
Some of the problems associated with models of screening for colorectal cancer are related to the multitude of factors and their interactions, which can potentially influence the outcome. Dr. Chelmowski is correct in suggesting that a markedly reduced cost of flexible sigmoidoscopy could render this procedure more cost-effective. Assuming perfect adherence and a sigmoidoscopy cost of less than $162, the incremental cost-effectiveness ratio of flexible sigmoidoscopy (compared with no screening) falls below that of the fecal occult blood test or colonoscopy. Assuming adherence rates of 75% for both repeated sigmoidoscopy every 5 years and colonoscopy after positive results on sigmoidoscopy, this threshold drops to $113.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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