Cost-effectiveness model for colon cancer screening

Research output: Contribution to journalArticle

286 Citations (Scopus)

Abstract

Background & Aims: The relative efficacy and effectiveness of different colon screening programs has not been assessed. The purpose of this analysis was to provide a model for comparing several colon screening programs and to determine the key variables that impact program effectiveness. Methods: Five screening programs were compared: annual fecal occult blood test (FOBT) alone, flexible sigmoidoscopy, flexible sigmoidoscopy and FOBT combined, one-time colonoscopy, and air-contrast barium enema. Key variables were adjusted for sensitivity analyses. Cost-effectiveness was defined as the cost per cancer death prevented. Results: FOBT alone prevents fewer cancer deaths than the other programs. The addition of flexible sigmoidoscopy to the FOBT increases the rate of cancer prevention. One-time colonoscopy has the greatest impact on colorectal cancer mortality, largely because of assumptions that cancer would be prevented in most patients who undergo polypectomy. FOBT alone is the most cost-effective of the programs, but the cost is sensitive to several key variables. Conclusions: The model shows key variables that impact the cost-effectiveness of colon screening programs. Compliance is an important determinant of effectiveness of all of the screening programs. Future study should be focused on methods of patient education that improve patient compliance with screening.

Original languageEnglish (US)
Pages (from-to)1781-1790
Number of pages10
JournalGastroenterology
Volume109
Issue number6
DOIs
StatePublished - 1995

Fingerprint

Occult Blood
Hematologic Tests
Early Detection of Cancer
Colonic Neoplasms
Cost-Benefit Analysis
Sigmoidoscopy
Colon
Patient Education
Colonoscopy
Costs and Cost Analysis
Neoplasms
Program Evaluation
Patient Compliance
Compliance
Colorectal Neoplasms
Air
Mortality

Keywords

  • fecal occult blood test
  • flexible sigmoidoscopy
  • FS

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Cost-effectiveness model for colon cancer screening. / Lieberman, David.

In: Gastroenterology, Vol. 109, No. 6, 1995, p. 1781-1790.

Research output: Contribution to journalArticle

@article{9b9ac5b92b35482781626d2b358a3787,
title = "Cost-effectiveness model for colon cancer screening",
abstract = "Background & Aims: The relative efficacy and effectiveness of different colon screening programs has not been assessed. The purpose of this analysis was to provide a model for comparing several colon screening programs and to determine the key variables that impact program effectiveness. Methods: Five screening programs were compared: annual fecal occult blood test (FOBT) alone, flexible sigmoidoscopy, flexible sigmoidoscopy and FOBT combined, one-time colonoscopy, and air-contrast barium enema. Key variables were adjusted for sensitivity analyses. Cost-effectiveness was defined as the cost per cancer death prevented. Results: FOBT alone prevents fewer cancer deaths than the other programs. The addition of flexible sigmoidoscopy to the FOBT increases the rate of cancer prevention. One-time colonoscopy has the greatest impact on colorectal cancer mortality, largely because of assumptions that cancer would be prevented in most patients who undergo polypectomy. FOBT alone is the most cost-effective of the programs, but the cost is sensitive to several key variables. Conclusions: The model shows key variables that impact the cost-effectiveness of colon screening programs. Compliance is an important determinant of effectiveness of all of the screening programs. Future study should be focused on methods of patient education that improve patient compliance with screening.",
keywords = "fecal occult blood test, flexible sigmoidoscopy, FS",
author = "David Lieberman",
year = "1995",
doi = "10.1016/0016-5085(95)90744-0",
language = "English (US)",
volume = "109",
pages = "1781--1790",
journal = "Gastroenterology",
issn = "0016-5085",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - Cost-effectiveness model for colon cancer screening

AU - Lieberman, David

PY - 1995

Y1 - 1995

N2 - Background & Aims: The relative efficacy and effectiveness of different colon screening programs has not been assessed. The purpose of this analysis was to provide a model for comparing several colon screening programs and to determine the key variables that impact program effectiveness. Methods: Five screening programs were compared: annual fecal occult blood test (FOBT) alone, flexible sigmoidoscopy, flexible sigmoidoscopy and FOBT combined, one-time colonoscopy, and air-contrast barium enema. Key variables were adjusted for sensitivity analyses. Cost-effectiveness was defined as the cost per cancer death prevented. Results: FOBT alone prevents fewer cancer deaths than the other programs. The addition of flexible sigmoidoscopy to the FOBT increases the rate of cancer prevention. One-time colonoscopy has the greatest impact on colorectal cancer mortality, largely because of assumptions that cancer would be prevented in most patients who undergo polypectomy. FOBT alone is the most cost-effective of the programs, but the cost is sensitive to several key variables. Conclusions: The model shows key variables that impact the cost-effectiveness of colon screening programs. Compliance is an important determinant of effectiveness of all of the screening programs. Future study should be focused on methods of patient education that improve patient compliance with screening.

AB - Background & Aims: The relative efficacy and effectiveness of different colon screening programs has not been assessed. The purpose of this analysis was to provide a model for comparing several colon screening programs and to determine the key variables that impact program effectiveness. Methods: Five screening programs were compared: annual fecal occult blood test (FOBT) alone, flexible sigmoidoscopy, flexible sigmoidoscopy and FOBT combined, one-time colonoscopy, and air-contrast barium enema. Key variables were adjusted for sensitivity analyses. Cost-effectiveness was defined as the cost per cancer death prevented. Results: FOBT alone prevents fewer cancer deaths than the other programs. The addition of flexible sigmoidoscopy to the FOBT increases the rate of cancer prevention. One-time colonoscopy has the greatest impact on colorectal cancer mortality, largely because of assumptions that cancer would be prevented in most patients who undergo polypectomy. FOBT alone is the most cost-effective of the programs, but the cost is sensitive to several key variables. Conclusions: The model shows key variables that impact the cost-effectiveness of colon screening programs. Compliance is an important determinant of effectiveness of all of the screening programs. Future study should be focused on methods of patient education that improve patient compliance with screening.

KW - fecal occult blood test

KW - flexible sigmoidoscopy

KW - FS

UR - http://www.scopus.com/inward/record.url?scp=0028793667&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028793667&partnerID=8YFLogxK

U2 - 10.1016/0016-5085(95)90744-0

DO - 10.1016/0016-5085(95)90744-0

M3 - Article

VL - 109

SP - 1781

EP - 1790

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 6

ER -