S1145 Costs of Guaiac Versus Immunochemical Fecal Occult Blood Testing Within a Randomized Population-Based Colorectal Cancer Screening Trial

Roon, Aafke H. van; Wilschut, Janneke; Leerdam, Monique E. van; Ballegooijen, Marjolein van; Vuuren, Anneke van; Francke, Jan; Reijerink, Jacqueline C.; Habbema, J.D.; Kuipers, Ernst J.

doi:10.1016/s0016-5085(10)60861-x

Cited by 3 publications

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“…Since FIT is currently not funded in Ontario, the costs of test kit and processing are unknown. Therefore we estimated the costs of FIT test kit and processing based on the difference between gFOBT and FIT in a Dutch screening trial[ 31 , 32 ], and applied this difference to the cost of gFOBT in Ontario. We assumed that the dispensing fee and communication of the test results would be identical to gFOBT.…”

Section: Methodsmentioning

confidence: 99%

Harms, benefits and costs of fecal immunochemical testing versus guaiac fecal occult blood testing for colorectal cancer screening

et al. 2017

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BackgroundThe ColonCancerCheck screening program for colorectal cancer (CRC) in Ontario, Canada, is considering switching from biennial guaiac fecal occult blood test (gFOBT) screening between age 50–74 years to the more sensitive, but also less specific fecal immunochemical test (FIT). The aim of this study is to estimate whether the additional benefits of FIT screening compared to gFOBT outweigh the additional costs and harms.MethodsWe used microsimulation modeling to estimate quality adjusted life years (QALYs) gained and costs of gFOBT and FIT, compared to no screening, in a cohort of screening participants. We compared strategies with various age ranges, screening intervals, and cut-off levels for FIT. Cost-efficient strategies were determined for various levels of available colonoscopy capacity.ResultsCompared to no screening, biennial gFOBT screening between age 50–74 years provided 20 QALYs at a cost of CAN$200,900 per 1,000 participants, and required 17 colonoscopies per 1,000 participants per year. FIT screening was more effective and less costly. For the same level of colonoscopy requirement, biennial FIT (with a high cut-off level of 200 ng Hb/ml) between age 50–74 years provided 11 extra QALYs gained while saving CAN$333,300 per 1000 participants, compared to gFOBT. Without restrictions in colonoscopy capacity, FIT (with a low cut-off level of 50 ng Hb/ml) every year between age 45–80 years was the most cost-effective strategy providing 27 extra QALYs gained per 1000 participants, while saving CAN$448,300.InterpretationCompared to gFOBT screening, switching to FIT at a high cut-off level could increase the health benefits of a CRC screening program without considerably increasing colonoscopy demand.

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Section: Methodsmentioning

confidence: 99%

Harms, benefits and costs of fecal immunochemical testing versus guaiac fecal occult blood testing for colorectal cancer screening

et al. 2017

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“…Costs for the test kits were based on prices from the manufacturer. Costs for analysis of the tests included material and personnel needed during the process of registration, analysis and authorisation of returned tests 34. The additional costs associated with two-sample FIT screening included double costs for FIT test kits and packaging material, and double costs for materials needed during the analysis of returned samples.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of one versus two sample faecal immunochemical testing for colorectal cancer screening

Goede

Roon

Reijerink

et al. 2012

Gut

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ObjectiveThe sensitivity and specificity of a single faecal immunochemical test (FIT) are limited. The performance of FIT screening can be improved by increasing the screening frequency or by providing more than one sample in each screening round. This study aimed to evaluate if two-sample FIT screening is cost-effective compared with one-sample FIT.DesignThe MISCAN–colon microsimulation model was used to estimate costs and benefits of strategies with either one or two-sample FIT screening. The FIT cut-off level varied between 50 and 200 ng haemoglobin/ml, and the screening schedule was varied with respect to age range and interval. In addition, different definitions for positivity of the two-sample FIT were considered: at least one positive sample, two positive samples, or the mean of both samples being positive.ResultsWithin an exemplary screening strategy, biennial FIT from the age of 55–75 years, one-sample FIT provided 76.0–97.0 life-years gained (LYG) per 1000 individuals, at a cost of €259 000–264 000 (range reflects different FIT cut-off levels). Two-sample FIT screening with at least one sample being positive provided 7.3–12.4 additional LYG compared with one-sample FIT at an extra cost of €50 000–59 000. However, when all screening intervals and age ranges were considered, intensifying screening with one-sample FIT provided equal or more LYG at lower costs compared with two-sample FIT.ConclusionIf attendance to screening does not differ between strategies it is recommended to increase the number of screening rounds with one-sample FIT screening, before considering increasing the number of FIT samples provided per screening round.

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Advance notification letters increase adherence in colorectal cancer screening: A population-based randomized trial

Roon

Hol

Wilschut

et al. 2011

Preventive Medicine

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S1145 Costs of Guaiac Versus Immunochemical Fecal Occult Blood Testing Within a Randomized Population-Based Colorectal Cancer Screening Trial

Cited by 3 publications

References 0 publications

Harms, benefits and costs of fecal immunochemical testing versus guaiac fecal occult blood testing for colorectal cancer screening

Harms, benefits and costs of fecal immunochemical testing versus guaiac fecal occult blood testing for colorectal cancer screening

Cost-effectiveness of one versus two sample faecal immunochemical testing for colorectal cancer screening

Advance notification letters increase adherence in colorectal cancer screening: A population-based randomized trial

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