Cost effectiveness and projected national impact of colorectal cancer screening in France

Hassan, Cesare; Bénamouzig, Robert; Spada, Cristiano; Ponchon, T; Zullo, Angelo; Saurin, JC; Costamagna, Guido

doi:10.1055/s-0030-1256409

Cited by 53 publications

(57 citation statements)

References 18 publications

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“…1,2 This growing need for endoscopic services is driving the search for more efficient and less costly procedures that minimize patient discomfort without compromising their safety. 3,4 Sedation is an important aspect of endoscopic procedures as it improves the quality of the examination, patient satisfaction, and patient adherence to screening and surveillance regimens. [4][5][6] With the vast majority of patients preferring to receive sedation, the cost that sedation adds to endoscopic procedures must also be considered.…”

mentioning

confidence: 99%

Propofol administration by endoscopists versus anesthesiologists in gastrointestinal endoscopy: a systematic review and meta-analysis of patient safety outcomes

Daza

Tan

Fielding

et al. 2018

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Background: With a growing demand for endoscopic services, the role of anesthesiologists in endoscopy units must be reassessed. The aim of this study was to compare patient outcomes in non-anesthesiologist-administered propofol (NAAP) versus anesthesiologist-administered propofol (AAP) during routine endoscopy. Methods:We systematically searched MEDLINE, CINAHL, Embase, Web of Science, CENTRAL and the grey literature for studies comparing NAAP and AAP. Primary outcomes included endoscopy-and sedation-related complications. Secondary outcomes included measures of endoscopy quality and of patient and endoscopist satisfaction. We reported treatment effects using random-effects models. Nonanesthesiologists administered lower propofol dosages than anesthesiologists (mean difference −61.79, 95% CI −114.46 to −9.12; 3443 patients), and their patients more commonly experienced awareness with recall (OR 19.99, 95% CI 7.88 to 50.76; 2090 patients). However, NAAP neither compromised patient willingness to repeat the procedure (OR 0.42, 95% CI 0.10 to 1.83; 2367 patients) nor lengthened total procedure time (mean difference −0.08, 95% CI −3.51 to 3.34; 2367 patients). Results Conclusion:Endoscopists may safely administer propofol without compromising procedural quality in patients classified as ASA I or II undergoing routine endoscopy. The results of this meta-analysis are limited by a lack of available high-quality studies. Further, large-scale studies are needed for definitive conclusions.Contexte : Étant donné que les services endoscopiques sont de plus en plus demandés, le rôle des anesthésiologistes dans les unités d'endoscopie doit être réévalué. Le but de cette étude était de comparer les résultats cliniques chez les patients selon que le propofol était administré par des non-anesthésiologistes (NAAP, pour nonanesthesiologist-administered propofol) ou par des anesthésiologistes (AAP, pour anesthesiologist-administered propofol).Méthodes : Nous avons procédé à une revue systématique des réseaux MEDLINE, CINAHL, Embase, Web of Science et CENTRAL et de la littérature grise pour recenser les études ayant comparé les méthodes NAAP et AAP. Les paramètres principaux incluaient les complications liées à l'endoscopie et à la sédation, et les paramètres secondaires incluaient les mesures de la qualité de l'endoscopie et la satisfaction des patients et des endoscopistes. Nous avons fait état des effets des traitements à l'aide de modèles à effets aléatoires.

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confidence: 99%

Propofol administration by endoscopists versus anesthesiologists in gastrointestinal endoscopy: a systematic review and meta-analysis of patient safety outcomes

Daza

Tan

Fielding

et al. 2018

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“…As to which test is the most cost effective in terms of CRC screening is a subject that is hotly debated, with evidence supporting each of the aforementioned modalities [84][85][86][87][88][89]. Cost-effectiveness analysis is mainly carried out by modeling, and heterogeneity in the comparative research methodology employed in different studies makes it difficult to draw comparisons and to decipher the 'true' cost-effectiveness between different screening strategies.…”

Section: Cost-effectiveness Analysismentioning

confidence: 99%

Screening for colorectal cancer: what fits best?

Lee

Leen

O’Moráin

et al. 2012

Expert Review of Gastroenterology & Hepatology

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“…Another interesting consideration, especially given the public health context of mass screening, is cost-effectiveness and how it correlates to specificity and sensitivity. Although uncertainty remains, the assessment of a screening program based on FIT for a one-year period in France seemed to be the most cost-effective approach (Hassan, et al, 2011). More research is necessary, as for example indicating what the best cut-off levels for colonoscopy referral are, without compromising sensitivity, to determine optimal public health approaches.…”

Section: Concepts and Definitionsmentioning

confidence: 99%

Early Detection of Colorectal Cancer and Population Screening Tests

Lionis¹,

Petelos²

2012

Colorectal Cancer - From Prevention to Patient Care

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Cost effectiveness and projected national impact of colorectal cancer screening in France

Abstract: A screening program based on FIT 1-year appeared to be the most cost-effective approach for CRC screening in France. However, a substantial uncertainty over this choice is still present.

Cited by 53 publications

References 18 publications

Propofol administration by endoscopists versus anesthesiologists in gastrointestinal endoscopy: a systematic review and meta-analysis of patient safety outcomes

Propofol administration by endoscopists versus anesthesiologists in gastrointestinal endoscopy: a systematic review and meta-analysis of patient safety outcomes

Screening for colorectal cancer: what fits best?

Early Detection of Colorectal Cancer and Population Screening Tests

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