Pecuniary compensation increases participation in screening for colorectal cancer

Aas, Eline

doi:10.1002/hec.1371

Cited by 12 publications

(13 citation statements)

References 35 publications

(46 reference statements)

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“… Jepson et al , () provided an extensive survey on determinants of screening participation. Compare also Aas (), Blom et al, (), Fukuda et al , (), Lange (), Meissner et al , (), Sabates & Feinstein (), Selvin & Brett (), Sambamoorthi & McAlpine (), Whynes et al , (), or Park & Kang () for more recent studies.…”

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confidence: 80%

The Effectiveness of Health Screening

Hackl¹,

Halla

Hummer³

et al. 2014

Health Economics

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in Forthcoming in Health EconomicsMarch 31, 2014 (First version: January 2012) AbstractUsing a matched insurant-general practitioner panel data set, we estimate the effect of a general health screening program on individuals' health status and health care cost. To account for selection into treatment we use regional variation in the intensity of exposure to supply-determined screening recommendations as an instrumental variable. We find that screening participation increases in-and outpatient health care cost up to two years after treatment substantially. In the medium-run, we find cost savings in the outpatient sector whereas, in the long-run, no statistically significant effects of screening on either health care cost component can be discerned. In sum, screening participation increases health care cost. Given that we do not find any statistically significant effect of screening participation on insurants' health status (at any point in time), we do not recommend a general health screening program. However, given that we find some evidence for cost-saving potential for the sub-sample of younger insurants, we suggest more targeted screening programs.

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confidence: 80%

The Effectiveness of Health Screening

Hackl¹,

Halla

Hummer³

et al. 2014

Health Economics

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“…We used the average 2010 gross monthly income of Norwegian women obtained from Statistics Norway (2011) and adjusted the wage to include social benefits paid by employers. Travel time and transportation costs associated with screening and follow-up visits were estimated from a prospective study of colorectal screening in Norway (Aas, 2009). The time spent travelling to a hospital to receive cervical cancer treatment was estimated from a health survey conducted by the Statistics Norway for the World Health Organization (2003).…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of cervical cancer screening with primary human papillomavirus testing in Norway

Burger

Ortendahl

et al. 2012

Br J Cancer

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Background:New screening technologies and vaccination against human papillomavirus (HPV), the necessary cause of cervical cancer, may impact optimal approaches to prevent cervical cancer. We evaluated the cost-effectiveness of alternative screening strategies to inform cervical cancer prevention guidelines in Norway.Methods:We leveraged the primary epidemiologic and economic data from Norway to contextualise a simulation model of HPV-induced cervical cancer. The current cytology-only screening was compared with strategies involving cytology at younger ages and primary HPV-based screening at older ages (31/34+ years), an option being actively deliberated by the Norwegian government. We varied the switch-age, screening interval, and triage strategies for women with HPV-positive results. Uncertainty was evaluated in sensitivity analysis.Results:Current cytology-only screening was less effective and more costly than strategies that involve switching to primary HPV testing in older ages. For unvaccinated women, switching at age 34 years to primary HPV testing every 4 years was optimal given the Norwegian cost-effectiveness threshold ($83 000 per year of life saved). For vaccinated women, a 6-year screening interval was cost-effective. When we considered a wider range of strategies, we found that an earlier switch to HPV testing (at age 31 years) may be preferred.Conclusions:Strategies involving a switch to HPV testing for primary screening in older women is expected to be cost-effective compared with current recommendations in Norway.

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“…72 However, nudging and biased information is controversial as it breaches with standard conceptions of the principle of autonomy. Correspondingly, incentives may increase uptake of CRC screening, 73 but has been rejected on moral grounds. 74 Providing balanced information has been identified as a substantial challenge.…”

Section: Autonomy Information and Consentmentioning

confidence: 99%