Cost‐effectiveness of colorectal cancer screening: Comparison of community‐based flexible sigmoidoscopy with fecal occult blood testing and colonoscopy

O'Leary, BA; Olynyk, John K.; Neville, A. Munro; Platell, Cameron

doi:10.1111/j.1440-1746.2004.03177.x

Cited by 81 publications

(77 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The risk of perforation after colonoscopy is approximately double that after sigmoidoscopy (24). Although estimates vary both between and within countries, costs of colonoscopy are about two to four times higher than costs of flexible sigmoidoscopy (3,25). If, as suggested by our analysis, its disadvantage in terms of risk reduction is much lower than commonly assumed, the relative merits of sigmoidoscopy compared with colonoscopy require careful reevaluation, which should also pay particular attention to gender-specific patterns.…”

Section: Discussionmentioning

confidence: 84%

Potential for Colorectal Cancer Prevention of Sigmoidoscopy Versus Colonoscopy: Population-Based Case Control Study

Brenner¹,

Chang‐Claude

Seiler

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

View full text Add to dashboard Cite

We aimed to estimate the proportions of colorectal cancer cases that might be prevented by sigmoidoscopy compared with colonoscopy among women and men. In a populationbased case control study conducted in Germany, 540 cases with a first diagnosis of primary colorectal cancer and 614 controls matched for age, sex, and county of residence were recruited. A detailed lifetime history of endoscopic examinations of the large bowel was obtained by standardized personal interviews, validated by medical records, and compared between cases and controls, paying particular attention to location of colorectal cancer and sex differences. Overall, 39%, 77%, and 64% of proximal, distal, and total colorectal cancer cases were estimated to be preventable by colonoscopy. The estimated proportion of total colorectal cancer cases preventable by sigmoidoscopy was 45% among both women and men, assuming that sigmoidoscopy reaches the junction of the descending and sigmoid colon only and findings of distal polyps are not followed by colonoscopy. Assuming that sigmoidoscopy reaches the splenic flexure and colonoscopy is done after detection of distal polyps, estimated proportions of total colorectal cancer preventable by sigmoidoscopy increase to 50% and 55% (73% and 91% of total colorectal cancer preventable by primary colonoscopy) among women and men, respectively. We conclude that colonoscopy provides strong protection against colorectal cancer among both women and men. The proportion of this protection achieved by sigmoidoscopy with follow-up colonoscopy in case of distal polyps may be larger than anticipated. Among men, this regimen may be almost as effective as colonoscopy, at least at previous performance levels of colonoscopy. (Cancer Epidemiol Biomarkers Prev 2007;16(3):494 -9)

show abstract

Section: Discussionmentioning

confidence: 84%

Potential for Colorectal Cancer Prevention of Sigmoidoscopy Versus Colonoscopy: Population-Based Case Control Study

Brenner¹,

Chang‐Claude

Seiler

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

View full text Add to dashboard Cite

show abstract

“…Na ocasião foram estudados e comparados, em relação a custo-efetividade, os exames de sangue oculto nas fezes, retossigmoidoscopia flexível, a combinação dos anteriores, e à colonoscopia (10,12,15,17) . Nos últimos anos, estudos comparativos têm enfatizado e indicado a colonoscopia como o exame inicial para o rastreamento do câncer colorretal devido sua melhor custo-efetividade em relação às outras opções de rastreamento, especialmente se considerados os níveis de adesão vislumbrados na Trabalho realizado na Fundação Rio-grandense Universitária de Gastroenterologia (FUGAST) e no Curso de Pós-graduação em Ciências Médicas da Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA).…”

Section: Introductionunclassified

Desenvolvimento de neoplasias/adenomas avançados colorretais no seguimento a longo prazo de pacientes submetidos a colonoscopia com polipectomia

Rostirolla

Pereira-Lima

Teixeira³

et al. 2009

Arq. Gastroenterol.

View full text Add to dashboard Cite

RESUMO -Contexto -A colonoscopia e a polipectomia diminuem a incidência do câncer colorretal, assim como a mortalidade dele decorrente. O intervalo efetivo entre os exames de seguimento é determinado por características clínicas e achados endoscópicos considerados como preditivos para o desenvolvimento de lesões neoplásicas colônicas avançadas. Objetivos -Avaliar a taxa de surgimento de lesões neoplásicas avançadas em pacientes submetidos a colonoscopias de seguimento em serviço de referência. INTRODUÇÃOO câncer colorretal é a quarta neoplasia maligna mais frequente no Brasil e a terceira causa de morte por câncer (4) . O número de óbitos pela doença no nosso País supera o causado por câncer de colo uterino na população feminina (4) . Sua incidência é maior nas regiões mais ricas, particularmente nos estados do sudeste e sul (4,6) . O Ministério da Saúde considera a necessidade crescente de um programa de rastreamento para sua detecção precoce com vistas à diminuição dos índices de mortalidade.A efetividade dos diferentes métodos de rastreamento foi analisada por força-tarefa do Serviço Preventivo dos Estados Unidos. Na ocasião foram estudados e comparados, em relação a custo-efetividade, os exames de sangue oculto nas fezes, retossigmoidoscopia flexível, a combinação dos anteriores, e à colonoscopia (10,12,15,17) . Nos últimos anos, estudos comparativos têm enfatizado e indicado a colonoscopia como o exame inicial para o rastreamento do câncer colorretal devido sua melhor custo-efetividade em relação às outras opções de rastreamento, especialmente se considerados os níveis de adesão vislumbrados na Trabalho realizado na Fundação Rio

show abstract

“…iFOBT is a simple and user-friendly test, which performs well, compared to other screening strategies such as flexible sigmoidoscopy in the general population. IFOBT screening for colorectal cancer is also costeffective, with an estimated incremental cost-effectiveness ratio of less than $50,000 per QALY compared to no screening in the general population (13,14,21).…”

Section: Screening For Colorectal Cancer In the General Populationmentioning

confidence: 99%

“…Similar programs were also developed in Scotland, Wales and Northern Ireland, with a recent extension of the Welch and English program extending to men and women aged 70 -74 (8)(9)(10). In Australia, iFOBT was first offered to those aged 50, 55 and 65 as part of the initial roll-out of the National Bowel Cancer Screening Program in 2006 (11)(12)(13)(14). Recent initiatives by cancer advocates and research groups have led to the continuing funding of the Program by the Australian Government in the next five years (15).…”

Section: Screening For Colorectal Cancer In the General Populationmentioning

confidence: 99%

“…We have conducted a series of systematic reviews and modelled economic evaluations of cancer screening in people with CKD, and found key sources of uncertainty around: patients' preferences and the costs and health outcomes of early cancer detection, the screening test accuracy in CKD, the treatment outcomes and the quality of life of patients with cancer and CKD (13,14,21,22). As such, we have four main reasons for conducting this program of work:…”

Section: Screening For Colorectal Cancer In the Ckd Populationmentioning

confidence: 99%

See 1 more Smart Citation

Test performance of faecal occult blood testing for the detection of bowel cancer in people with chronic kidney disease (DETECT) protocol

et al. 2011

View full text Add to dashboard Cite

Background: Cancer is a major cause of mortality and morbidity in patients with chronic kidney disease (CKD). In patients without kidney disease, screening is a major strategy for reducing the risk of cancer and improving the health outcomes for those who developed cancers by detecting treatable cancers at an early stage. Among those with CKD, the effectiveness, the efficacy and patients' preferences for cancer screening are unknown. Methods/Design: This work describes the protocol for the DETECT study examining the effectiveness, efficiency and patient's perspectives of colorectal cancer screening using immunochemical faecal occult blood testing (iFOBT) for people with CKD. The aims of the DETECT study are 1) to determine the test performance characteristics of iFOBT screening in individuals with CKD, 2) to estimate the incremental costs and health benefits of iFOBT screening in CKD compared to no screening and 3) to elicit patients' perspective for colorectal cancer screening in the CKD population. Three different study designs will be used to explore the uncertainties surrounding colorectal cancer screening in CKD. A diagnostic test accuracy study of iFOBT screening will be conducted across all stages of CKD in patients ages 35-70. Using individually collected direct healthcare costs and outcomes from the diagnostic test accuracy study, cost-utility and cost-effective analyses will be performed to estimate the costs and health benefits of iFOBT screening in CKD. Qualitative in-depth interviews will be undertaken in a subset of participants from the diagnostic test accuracy study to investigate the perspectives, experiences, attitudes and beliefs about colorectal cancer screening among individuals with CKD. Discussion: The DETECT study will target the three major unknowns about early cancer detection in CKD. Findings from our study will provide accurate and definitive estimates of screening efficacy and efficiency for colorectal cancer, and will allow better service planning and budgeting for early cancer detection in this at-risk population. The DETECT study is also registered with the Australia New Zealand Clinical Trials Registry ACTRN12611000538943

show abstract

Cost‐effectiveness of colorectal cancer screening: Comparison of community‐based flexible sigmoidoscopy with fecal occult blood testing and colonoscopy

Abstract: Flexible sigmoidoscopy and colonoscopy are cost-effective strategies for reducing the disease burden of colorectal cancer.

Cited by 81 publications

References 27 publications

Potential for Colorectal Cancer Prevention of Sigmoidoscopy Versus Colonoscopy: Population-Based Case Control Study

Potential for Colorectal Cancer Prevention of Sigmoidoscopy Versus Colonoscopy: Population-Based Case Control Study

Desenvolvimento de neoplasias/adenomas avançados colorretais no seguimento a longo prazo de pacientes submetidos a colonoscopia com polipectomia

Test performance of faecal occult blood testing for the detection of bowel cancer in people with chronic kidney disease (DETECT) protocol

Contact Info

Product

Resources

About