Colorectal Cancer Screening for Average-Risk North Americans: An Economic Evaluation

Heitman, Steven J.; Hilsden, Robert J.; Au, Flora; Dowden, Scot; Manns, Braden

doi:10.1371/journal.pmed.1000370

Cited by 122 publications

(145 citation statements)

References 71 publications

(99 reference statements)

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“…Other analyses have also shown screening for crc to be cost-effective 27,28,30 . Many of the screening scenarios under consideration will result in financial savings 59 where results are influenced by the discount rate, which affects the relative value of the short-term and long-term costs and benefits.…”

Section: Discussionmentioning

confidence: 99%

Using the Cancer Risk Management Model to Evaluate Colorectal Cancer Screening Options for Canada

Coldman¹,

Phillips²,

Brisson

et al. 2015

Current Oncology

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strategies, fobt parameter values associated with high-sensitivity formulations were associated with a substantial increase in test effectiveness. The fit was more cost-effective at the 50 ng/mL threshold than at the 100 ng/mL threshold. ConclusionsThe crmm-crc provides a sophisticated and flexible environment in which to evaluate crc control options. All screening scenarios considered in this study effectively reduced crc mortality, although sensitivity analyses demonstrated some uncertainty in the magnitude of the improvements. Where possible, local data should be used to reduce uncertainty in the parameters.

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Section: Discussionmentioning

confidence: 99%

Using the Cancer Risk Management Model to Evaluate Colorectal Cancer Screening Options for Canada

Coldman¹,

Phillips²,

Brisson

et al. 2015

Current Oncology

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show abstract

“…These studies have shown that FIT is highly sensitive for detecting CRC, its accuracy for AN is adequate and it is a cost-effective test in the CRC screening setting. [20][21][22][23][24][25][26][27][28][29][30] However, no studies have compared the diagnostic accuracy between these populations of a quantitative FIT so far. Only one recently published study has compared the diagnostic yield of a qualitative FIT in these two populations, and the authors did not find differences in FIT yield either.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of fecal immunochemical test in average‐ and familial‐risk colorectal cancer screening

et al. 2014

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Background: There is little information about the fecal immunochemical test (FIT) in familial-risk colorectal cancer (CRC) screening. Objectives: The objective of this article is to investigate whether FIT diagnostic accuracy for advanced neoplasia (AN) differs between average and familial-risk (first-degree relative) patients. Methods: A total of 1317 consecutive participants (595 familial) who collected one stool sample before performing a colonoscopy as a CRC screening test were included. FIT diagnostic accuracy for AN was evaluated with Chi-square test at a 20 mg hemoglobin/g of feces cut-off value. Finally, we determined which variables were independently related to AN. Results: An AN was found in 151 (11.5%) patients. The overall accuracy was not statistically different between both cohorts for AN (88.4%, 91.7%; p ¼ 0.051). At the cut-off stablished, differences in FIT sensitivity (31.1%, 40.6%; p ¼ 0.2) or specificity (96.5%, 97.3%; p ¼ 0.1) were not statistically significant. Finally, independent variables such as sex (male) (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.4-3.1), age (50-65, >65 years) (OR 2.1, 95% CI 1.1-4.3; OR 2.7, 95% CI 1.2-6.1), previous colonoscopy (OR 0.4, 95% CI 0.2-0.9) and FIT 20 mg/g feces (OR 17.7, 95% CI 10.8-29.1) were associated with AN diagnosis. Conclusions: FIT accuracy for AN detection is equivalent in average and familial-risk CRC screening cohorts.

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“…1 Evidence from several studies have demonstrated that colorectal cancer screening is effective [2][3][4][5] and cost effective 6 in populations that are at average risk of developing the disease. Searching for occult blood in stools using the guaiac test and, more recently, the faecal immunochemical test (FIT) are predominantly implemented in Europe 7 and Australia 8 , whereas colonoscopy is the dominant screening modality in North America 9 .…”

Section: Introductionmentioning

confidence: 99%

Alerts in electronic medical records to promote a colorectal cancer screening programme: a cluster randomised controlled trial in primary care

et al. 2016

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Colorectal Cancer Screening for Average-Risk North Americans: An Economic Evaluation

Abstract: An economic analysis of different screening methods for detection of colorectal cancers suggests that in US or Canadian settings, screening with fecal immunochemical testing results in lower health-care costs as compared with other screening approaches.

Cited by 122 publications

References 71 publications

Using the Cancer Risk Management Model to Evaluate Colorectal Cancer Screening Options for Canada

Using the Cancer Risk Management Model to Evaluate Colorectal Cancer Screening Options for Canada

Diagnostic accuracy of fecal immunochemical test in average‐ and familial‐risk colorectal cancer screening

Alerts in electronic medical records to promote a colorectal cancer screening programme: a cluster randomised controlled trial in primary care

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