Michael Pignone, MD, MPH; Somnath Saha, MD, MPH; Tom Hoerger, PhD; Jeanne Mandelblatt, MD, MPH
Pignone M, Saha S, Hoerger T, Mandelblatt J. Cost-Effectiveness Analyses of Colorectal Cancer Screening: A Systematic Review for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;137:96-104. doi: 10.7326/0003-4819-137-2-200207160-00007
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Published: Ann Intern Med. 2002;137(2):96-104.
It is unclear which colorectal cancer screening strategy is most cost-effective.
On behalf of the U.S. Preventive Services Task Force, the authors reviewed seven published analyses that addressed the cost-effectiveness of fecal occult blood testing (single or annual), flexible sigmoidoscopy every 5 years alone or with fetal occult blood testing, barium enema every 5 years, and colonoscopy every 10 years.
The screening strategies all cost $10 000 to $25 000 per year of life saved.
Physicians should discuss the advantages and disadvantages of the various colorectal cancer screening strategies with their patients to decide which test is best for each individual.
What is the cost-effectiveness of colorectal cancer screening by any method compared with no screening?
Can we use incremental cost-effectiveness data to determine the relative effectiveness and cost-effectiveness of different screening options and thus determine whether there is a preferred strategy for screening?
What is the incremental cost-effectiveness of continuing screening to 85 years of age compared with stopping screening at 70, 75, or 80 years of age? What is the incremental cost-effectiveness of starting screening at 40 or 45 years of age compared with 50 years of age?
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Appendix Table 2.
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Cancer Screening/Prevention, Colorectal Cancer, Gastroenterology/Hepatology, Gastrointestinal Cancer, Healthcare Delivery and Policy.
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