Cost-effectiveness analysis of colonoscopy and fecal immunochemical testing for colorectal cancer screening in China

Ren, Yinan; Zhao, Mingye; Zhou, Dachuang; Xing, Qinghe; Gong, Fangfang; Tang, Wenxi

doi:10.3389/fpubh.2022.952378

Cited by 7 publications

(6 citation statements)

References 60 publications

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“…8 Ren et al developed a periodic FIT-based and Cost-benefit of one-time colonoscopy colonoscopy-based strategy, compared the cost-effectiveness of the Chinese insurance system, and found that the FIT-based strategy was more cost-effective for all ages. 19 In a meta-analysis of CEA comparing single colonoscopy with multiple FITs, the FIT-based strategy was more cost-effective. 20 This model is a screening strategy based on multiple colonoscopies or FITs, which are difficult to implement owing to the limited medical resources available.…”

Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness analysis of single colonoscopy versus single fecal test for colorectal cancer diagnosis and treatment

Ishibashi,

Suzuki,

Kobayashi

et al. 2024

J of Gastro and Hepatol

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Background and AimRegular endoscopy or fecal immunochemical test (FIT) is ideal for screening colorectal cancer. However, only a limited number of individuals undergo regular screening. This study aimed to compare the cost‐effectiveness of a single colonoscopy with a single FIT performed for colorectal cancer screening.MethodsA microsimulation model was constructed based on real‐world observational data collected from three institutions between 2019 and 2022 that compared colonoscopy‐based screening with FIT‐based screening. The total costs of diagnosis and treatment of the detected lesions using the two strategies were calculated. The incremental cost‐effectiveness ratio (ICER) per life year gained (LYG) of the colonoscopy‐based strategy was calculated.ResultsData from 11 407 patients undergoing colonoscopies and 59 176 patients undergoing FITs were used to establish a model. In the base case analysis of screening strategies, colonoscopy was more cost‐effective than FIT (ICER 415 193 yen/LYG). The ICER of the colonoscopy‐based strategy among 60‐ to 69‐year‐old patients was lowest at 394 200 yen/LYG, whereas that in 20‐ to 29‐year‐old patients was highest. Monte Carlo simulations showed that the colonoscopy‐based strategy was more cost‐effective than the FIT‐based strategy (net monetary benefit [NMB]: 5 695 957 yen vs 5 348 253 yen). When the adenoma detection rate in the colonoscopy was over 30% or the positive FIT rate was lower than 8.6% in the FIT‐based strategy, the NMB of the colonoscopy‐based strategy exceeded that of the FIT‐based strategy.ConclusionIn the microsimulation model, colonoscopy is recommended as a one‐time screening procedure in patients aged >60 years with >30% ADR or <8.6% positive FIT rate.

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Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness analysis of single colonoscopy versus single fecal test for colorectal cancer diagnosis and treatment

Ishibashi,

Suzuki,

Kobayashi

et al. 2024

J of Gastro and Hepatol

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“…Conventional methods for the diagnosis of CRC have their own obvious shortcomings, such as poor patient compliance rate in colonoscopy and low diagnostic accuracy in FOBT, FIT and other serum tumor biomarkers [3][4][5][6][7]. Consequently, developing a noninvasive and reliable method for detecting CRC is critical.…”

Section: Discussionmentioning

confidence: 99%

“…At present, some conventional methods for CRC detection, such as colonoscopy (the gold standard for CRC diagnosis), fecal occult blood test (FOBT) or fecal immunochemical test (FIT) (the most widely used screening biomarkers for CRC diagnosis) and carcinoembryonic antigen (CEA) or carbohydrate antigen-199 (CA199) all contain several limitations, such as uncomfortable experience, high costs, susceptible to interference, low sensitivity and low speci city [3][4][5][6][7]. Thus, identifying a patient-friendly approach with high diagnostic accuracy is crucial to improve the clinical outcome of CRC patients.…”

Section: Introductionmentioning

confidence: 99%

Clinical predictive value of methylated SEPT9 combined with NLR, PLR and LMR in colorectal cancer

Yan

Huang

Deng

et al. 2023

Preprint

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Purpose This study aimed to investigate clinical predictive values of methylated septin9 (mSEPT9) combined with neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) in colorectal cancer (CRC).Methods 329 subjects composed of 114 CRC patients, 105 polyps patients and 104 healthy participants were prospectively recruited. Clinicopathologic features were collected and analyzed. Plasma samples were collected for mSEPT9, NLR, PLR and LMR test. The sensitivity, specificity and area under the curve (AUC) of each biomarker separately or in combination were estimated by the receiver operating characteristic (ROC) curve.Results The levels of NLR and PLR and the positive detection rate (PDR) of mSEPT9 in CRC patients were obviously higher than non-CRC subjects, while LMR was the opposite. The PDR of mSEPT9 in CRC patients was significantly correlated with age, tumor size, tumor stage and M stage. ROC curve analysis demonstrated moderate diagnostic values of mSEPT9, NLR, PLR and LMR in CRC patients with AUC of 0.78 (Se = 0.68, and Sp = 0.89), 0.78 (Se = 0.68, and Sp = 0.83), 0.80 (Se = 0.68, and Sp = 0.81), and 0.77 (Se = 0.72, and Sp = 0.73), respectively. Combination of these four biomarkers dramatically enhanced the diagnostic accuracy of CRC (AUC = 0.92, Se = 0.90, and Sp = 0.87), especially CRC patients with large tumors (AUC = 0.95) or distal metastasis (AUC = 0.95).Conclusion mSEPT9, NLR, PLR and LMR showed the potential to be reliable biomarkers for the diagnosis of CRC. Combination of all together further improved the diagnostic accuracy of CRC.

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“…The annual transition probabilities from one status to another were used as the input. For the annual transition probability of CRC, we referred to the value reported by Ren et al 11 and Li et al 12 (from non-advanced adenoma to advanced adenoma, 2%; from advanced adenoma to local cancer: 4.4%; from local to regional cancer, 30% [25–35%]; and from regional to distant cancer, 50% [45–55%]).…”

Section: Methodsmentioning

confidence: 99%

Cost-Utility Analysis for Colorectal Cancer Screening According to the Initiating Age of National Cancer Screening Program in Korea

Bae,

Lee,

Kim

et al. 2024

J Korean Med Sci

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Background This study aimed to identify the most cost-effective strategy for colorectal cancer screening using the fecal immunochemical test (FIT), focusing on screening initiation age in Korea. Methods We designed Markov simulation models targeting individuals aged 40 years or older. Twelve strategies combining screening initiation ages (40, 45, or 50 years old), termination ages (80 or no limit), and intervals (1 or 2 years) were modeled, and the most cost-effective strategy was selected. The robustness of the results was confirmed using one-way and probabilistic sensitivity analyses. Furthermore, the cost-effectiveness of the qualitative and quantitative FIT methods was verified using scenario analysis. Results The 2-year interval strategy with a screening age range of 45–80 years was the most cost-effective (incremental cost-utility ratio = KRW 7,281,646/quality adjusted life years). The most sensitive variables in the results were transition rate from advanced adenoma to local cancer and discount rate. The uncertainty in the model was substantially low. Moreover, strategies starting at the age of 40 years were also cost-effective but considered suboptimal. The scenario analysis showed that there was no significant difference in cost-effectiveness between strategies with various relative screening ratio of quantitative and qualitative method. Conclusion The screening method for advancing the initiation age, as presented in the 2015 revised national screening recommendations, was superior regarding cost-effectiveness. This study provides a new paradigm for the development of a national cancer screening system in Korea, which can be utilized as a scientific basis for economic evaluations.

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Cost-effectiveness analysis of colonoscopy and fecal immunochemical testing for colorectal cancer screening in China

Cited by 7 publications

References 60 publications

Cost‐effectiveness analysis of single colonoscopy versus single fecal test for colorectal cancer diagnosis and treatment

Cost‐effectiveness analysis of single colonoscopy versus single fecal test for colorectal cancer diagnosis and treatment

Clinical predictive value of methylated SEPT9 combined with NLR, PLR and LMR in colorectal cancer

Cost-Utility Analysis for Colorectal Cancer Screening According to the Initiating Age of National Cancer Screening Program in Korea

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