| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Evidence-based Practice |
1 From the Department of Radiology, Decision Analysis and Technology Assessment Group, Massachusetts General Hospital, Zero Emerson Place, Ste 2H, Boston, MA 02114 (P.M.M., J.L.B., S.G., E.F.H., J.S.L., G.S.G.); and the Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass (G.S.G.). Received June 19, 2000; revision requested July 28; revision received August 21; accepted October 2. Address correspondence to G.S.G.
PURPOSE: To determine the most cost-effective colorectal cancer screening strategy costing less than $100,000 per life-year saved and to determine how available strategies compare with each other.
MATERIALS AND METHODS: Standardized methods were used to calculate incremental cost-effectiveness ratios (ICERs) from published estimates of cost and effectiveness of colorectal cancer screening strategies, and the direction and magnitude of any effect on the ratio from parameter estimate adjustments based on literature values were estimated.
RESULTS: Strategies in which double-contrast barium enema examination was performed emerged as optimal from all studies included. In average-risk individuals, screening with double-contrast barium enema examination every 3 years, or every 5 years with annual fecal occult blood testing, had an ICER of less than $55,600 per life-year saved. However, double-contrast barium enema examination screening every 3 years plus annual fecal occult blood testing had an ICER of more than $100,000 per life-year saved. Colonoscopic screening had an ICER of more than $100,000 per life-year saved, was dominated by other screening strategies, and offered less benefit than did double-contrast barium enema examination screening.
CONCLUSION: Double-contrast barium enema examination can be a cost-effective component of colorectal cancer screening, but further modeling efforts are necessary.
Index terms: Cancer screening, 75.1282, 75.30 • Colon neoplasms, diagnosis, 75.1282, 75.30 • Colonoscopy • Cost-effectiveness
This article has been cited by other articles:
|
|
 |
|
  H. Brenner, M. Hoffmeister, C. Stegmaier, G. Brenner, L. Altenhofen, and U. Haug Risk of progression of advanced adenomas to colorectal cancer by age and sex: estimates based on 840 149 screening colonoscopies Gut, November 1, 2007; 56(11): 1585 - 1589. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. Kung, M. S. Levine, S. N. Glick, P. Lakhani, S. E. Rubesin, and I. Laufer Colorectal Cancer: Screening Double-Contrast Barium Enema Examination in Average-Risk Adults Older Than 50 Years Radiology, September 1, 2006; 240(3): 725 - 735. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Boer, S. Plevritis, and L. Clarke Diversity of model approaches for breast cancer screening: a review of model assumptions by The Cancer Intervention and Surveillance Network (CISNET) Breast Cancer Groups Statistical Methods in Medical Research, December 1, 2004; 13(6): 525 - 538. [Abstract] [PDF]
|
|
|
|
 |
|
 M. Pignone, S. Saha, T. Hoerger, and J. Mandelblatt Cost-Effectiveness Analyses of Colorectal Cancer Screening: A Systematic Review for the U.S. Preventive Services Task Force Ann Intern Med, July 16, 2002; 137(2): 96 - 104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M. Friedenberg The 21st Century: The Age of Screening Radiology, April 1, 2002; 223(1): 1 - 4. [Full Text] [PDF]
|
|
|
|
|
|
M. S. Levine, S. N. Glick, S. E. Rubesin, and I. Laufer Double-Contrast Barium Enema Examination and Colorectal Cancer: A Plea For Radiologic Screening Radiology, February 1, 2002; 222(2): 313 - 315. [Full Text] [PDF]
|
|
