Budget Impact Analysis of Against Colorectal Cancer In Our Neighborhoods (ACCION): A Successful Community-Based Colorectal Cancer Screening Program for a Medically Underserved Minority Population

Abstract

The budget impact mainly derived from colonoscopy-related costs incurred for the high-risk group. The effectiveness of FIT to detect CRC was critically dependent on follow-up after positive FIT. Community cancer prevention programs need reliable estimates of the cost of CRC screening promotion and the added budget impact of screening with colonoscopy.

Economics of Multicomponent Interventions to Increase Breast, Cervical, and Colorectal Cancer Screening: A Community Guide Systematic Review

“…A total of 40 studies 14–21,24–27,29,31–33,35–38,40–42,45,46,48,50,52,54–65 were conducted in the U.S., and 13 studies 22,23,28,30,34,39,43,44,47,49,51,53,66 were conducted in other high-income countries. 13 The U.S. studies were distributed in the following geographic regions: Northeast, 15,18,24,37,38,46,50,52,58,62,63 Southeast, 17,18,26,27,55,64,65 Midwest, 14,16,25,36,42,45,54 Southwest, 19,20,29,33,35,56,59–61 and West. 21,29–32,40,41,48,57 There were non-U.S. studies from Japan 22 and Spain 23 for breast cancer; from Japan 28 and Canada 30 for cervical cancer; and from Netherlands, 34,39 France, 47,49,53 Hong Kong, 51 South Korea, 66 and Italy 43,44 for colorectal cancer.…”

“…14–17,20–22,24,25,29–32,34–43,45–50,52–54,56–58,62,64,66 Most included cost-effectiveness analyses, reporting ICERs, 14–16,18,20–24,26,27,29–33,35–38,40,41,45,47,49,57,60,62,64–66 whereas some reported only cost estimates. 17,19,25,28,34,39,42–44,46,48,54–56,58,59,61 Only one study reported cost–benefit estimates. 63 Of the studies reporting cost-effectiveness estimates, the majority had comparators that did not receive an intervention (usual-care group).…”

“…14–16,18,20–22,27,29–31,33,35–38,40,41,47,49,57,60,62,66 Other studies had comparators that contained a single intervention component. 23,24,26,32,45,64,65 For colorectal cancer, identified studies focused on increasing colorectal cancer screening through FOBT/fecal immunochemical testing, 24,35,36,39–50,52–54,56,57,59,61,62,64–66 flexible sigmoidoscopy, 55 and colonoscopy. 18,34,37,38,51,58,60,63…”

“…15,19–33,39–61,64–66 Most of the studies across all three cancers had MCIs with two intervention components. 14,16,17,20,23,25–29,32,34–52,62,63,66 Other studies contained three components, 19,22,24,33,53–56,64 four components, 18,30,31,57–59,65 five components, 15,21 six components, 60 or seven components. 61 For breast cancer screening, the most common intervention component was client reminders (30% of breast cancer MCI study arms).…”

“…The most common way to reduce structural barriers was appointment scheduling assistance for breast cancer screening, 15,18,24,26,27 transportation assistance for cervical cancer, 30–32 and alternative screening through mailing of FOBT kits for colorectal cancer. 39–48,50–55,57,59,61,62,64–66…”