Prevention, Screening and Treatment of Colorectal Cancer: a Global and Regional Generalized Cost Effectiveness Analysis

Overview

Journal Cost Eff Resour Alloc

Publisher Biomed Central

Date 2010 Mar 19

PMID 20236531

Citations 12

Authors

Gary M Ginsberg

Stephen S Lim

Jeremy A Lauer

Benjamin P Johns

Cecilia R Sepulveda

Affiliations

Soon will be listed here.

Abstract

Background: Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented.

Methods: Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs.

Results: In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others.In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario) would not be cost effective.In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment.

Conclusions: From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage.

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References

Johns B, Baltussen R, Hutubessy R . Programme costs in the economic evaluation of health interventions. Cost Eff Resour Alloc. 2003; 1(1):1. PMC: 156020. DOI: 10.1186/1478-7547-1-1. View

Berchi C, Bouvier V, Reaud J, Launoy G . Cost-effectiveness analysis of two strategies for mass screening for colorectal cancer in France. Health Econ. 2004; 13(3):227-38. DOI: 10.1002/hec.819. View

Frazier A, Colditz G, Fuchs C, Kuntz K . Cost-effectiveness of screening for colorectal cancer in the general population. JAMA. 2000; 284(15):1954-61. DOI: 10.1001/jama.284.15.1954. View

Norat T, Lukanova A, Ferrari P, Riboli E . Meat consumption and colorectal cancer risk: an estimate of attributable and preventable fractions. IARC Sci Publ. 2002; 156:223-5. View

Lejeune C, Arveux P, Dancourt V, Fagnani F, Bonithon-Kopp C, Faivre J . A simulation model for evaluating the medical and economic outcomes of screening strategies for colorectal cancer. Eur J Cancer Prev. 2003; 12(1):77-84. DOI: 10.1097/00008469-200302000-00012. View

Frank L, Andresen M, Schmid T . Obesity relationships with community design, physical activity, and time spent in cars. Am J Prev Med. 2004; 27(2):87-96. DOI: 10.1016/j.amepre.2004.04.011. View

Morton G, Bowler I . Combined spinal-epidural as an alternative method of anaesthesia for a sigmoid-colectomy. Anaesthesia. 2001; 56(8):815-6. DOI: 10.1046/j.1365-2044.2001.02181-27.x. View

Ness R, Holmes A, Klein R, Dittus R . Cost-utility of one-time colonoscopic screening for colorectal cancer at various ages. Am J Gastroenterol. 2000; 95(7):1800-11. DOI: 10.1111/j.1572-0241.2000.02172.x. View

Winawer S, Fletcher R, Miller L, Godlee F, Stolar M, Mulrow C . Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology. 1997; 112(2):594-642. DOI: 10.1053/gast.1997.v112.agast970594. View

10.

Hutubessy R, Baltussen R, Evans D, Barendregt J, Murray C . Stochastic league tables: communicating cost-effectiveness results to decision-makers. Health Econ. 2001; 10(5):473-7. DOI: 10.1002/hec.614. View

11.

Murray C, Evans D, Acharya A, Baltussen R . Development of WHO guidelines on generalized cost-effectiveness analysis. Health Econ. 2000; 9(3):235-51. DOI: 10.1002/(sici)1099-1050(200004)9:3<235::aid-hec502>3.0.co;2-o. View

12.

Chapman I . Adenomatous polypi of large intestine: incidence and distribution. Ann Surg. 1963; 157:223-6. PMC: 1466434. DOI: 10.1097/00000658-196302000-00007. View

13.

Ladabaum U, CHOPRA C, Huang G, Scheiman J, Chernew M, Fendrick A . Aspirin as an adjunct to screening for prevention of sporadic colorectal cancer. A cost-effectiveness analysis. Ann Intern Med. 2001; 135(9):769-81. DOI: 10.7326/0003-4819-135-9-200111060-00007. View

14.

Guilbert J . The world health report 2002 - reducing risks, promoting healthy life. Educ Health (Abingdon). 2004; 16(2):230. DOI: 10.1080/1357628031000116808. View

15.

Salkeld G, Young G, Irwig L, Haas M, Glasziou P . Cost-effectiveness analysis of screening by faecal occult blood testing for colorectal cancer in Australia. Aust N Z J Public Health. 1996; 20(2):138-43. DOI: 10.1111/j.1753-6405.1996.tb01807.x. View

16.

Rex D, Lehman G, Hawes R, Ulbright T, Smith J . Screening colonoscopy in asymptomatic average-risk persons with negative fecal occult blood tests. Gastroenterology. 1991; 100(1):64-7. DOI: 10.1016/0016-5085(91)90583-7. View

17.

Rickert R, AUERBACH O, GARFINKEL L, HAMMOND E, FRASCA J . Adenomatous lesions of the large bowel: an autopsy survey. Cancer. 1979; 43(5):1847-57. DOI: 10.1002/1097-0142(197905)43:5<1847::aid-cncr2820430538>3.0.co;2-l. View

18.

DiSario J, Foutch P, Mai H, Pardy K, Manne R . Prevalence and malignant potential of colorectal polyps in asymptomatic, average-risk men. Am J Gastroenterol. 1991; 86(8):941-5. View

19.

Rubin P, Waye J . Colonoscopic polypectomy: a critical review of recent literature. Curr Gastroenterol Rep. 2006; 8(5):430-3. DOI: 10.1007/s11894-006-0030-8. View

20.

Vijan S, Hwang E, Hofer T, Hayward R . Which colon cancer screening test? A comparison of costs, effectiveness, and compliance. Am J Med. 2002; 111(8):593-601. DOI: 10.1016/s0002-9343(01)00977-9. View