Medicare cost of colorectal cancer screening: CT colonography vs. optical colonoscopy

Abstract

Purpose: To compare the Medicare population cost of colorectal cancer (CRC) screening of average risk individuals by CT colonography (CTC) vs. optical colonoscopy (OC). Methods: The authors used Medicare claims data, fee schedules, established protocols, and other sources to estimate CTC and OC per-screen costs, including the costs of OC referrals for a subset of CTC patients. They then modeled and compared the Medicare costs of patients who complied with CTC and OC screening recommendations and tested alternative scenarios. Results: CTC is 29% less expensive than OC for the Medicare population in the base scenario. Although the CTC cost advantage is increased or reduced under alternative scenarios, it is always positive. Conclusion: CTC is a cost-effective CRC screening option for the Medicare population and will likely reduce Medicare expenditures for CRC screening.Electronic supplementary materialThe online version of this article (doi:10.1007/s00261-015-0538-1) contains supplementary material, which is available to authorized users.

CT Colonographic Screening of Patients With a Family History of Colorectal Cancer: Comparison With Adults at Average Risk and Implications for Guidelines

“…The reduced invasiveness makes it safer, more convenient, preferred by patients over colonoscopy, 36-38 and more cost-effective. 39,40 When presented with the screening options of OC and CTC, considerably more individuals choose CTC, leading to increased adherence. 41,42 The cross-sectional nature of CTC also provides opportunities for screening for additional conditions, including aortic aneurysm and osteoporosis.…”

Cardiovascular pre-participation screening in the young athlete: addressing concerns

“…In the USA, the threshold of $50,000 has persisted in that it is generally accepted that interventions that cost less than $50,000 [46] to $60,000 [47] per QALY gained are considered cost effective [48]. When comparing ECG screening to other screening programs in the USA [49], such as for breast [50], colon [51], or lung cancer [52], especially when considering the number of life-years gained by such a screening program, or when compared to other procedures of modern healthcare, such as dialysis, ECG screening falls within the cost-effectiveness threshold. Given that ECG screening would be done at such a young age affording the patient many years of productive life assuming medical interventions following early detection resulted in reduced mortality, an analysis incorporating QALY would be interesting, and would likely strengthen the argument to include ECG screening in young athletes at risk for SCD.…”

Accuracy of Combined Computed Tomography Colonography and Dual Energy Iiodine Map Imaging for Detecting Colorectal masses using High-pitch Dual-source CT

“…CTC is an attractive alternative to optical colonoscopy because it is noninvasive and is performed without administration of analgesics or sedation, no abdominal pain during and after the procedure, no complications due obstructions, thus minimizing the risks inherent to colonoscopy. It is currently mainly in the investigation of symptomatic patients, elsewhere it is strongly advocated for colorectal cancer screening 4 . Meta-analysis data suggests CTC is effective in detecting significant colonic neoplasia, notably cancer and large polyps ≥1 cm 5 .…”