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Title: The potential of imaging techniques as a screening tool for colorectal cancer: a cost-effectiveness analysis
Authors: Greuter MJ; Berkhof J; Fijneman RJ; Demirel E; Lew JB; Meijer GA; Stoker J; Coupé VM
Categories: Cancer Type - Bowel & Colorectal Cancer
Cancer Control, Survivorship, and Outcomes Research - Health Services, Economic and Health Policy Analyses
Year: 2016
Journal Title: British Journal of Radiology
Volume: 89
Issue: 1063
Citation: Greuter MJ, Berkhof J, Fijneman RJ, Demirel E, Lew JB, Meijer GA, Stoker J, Coupé VM. The potential of imaging techniques as a screening tool for colorectal cancer: a cost-effectiveness analysis. Br J Radiol. 2016;89(1063):20150910
Abstract: OBJECTIVE: Imaging may be promising for colorectal cancer (CRC) screening, since it has test characteristics comparable with colonoscopy but is less invasive. We aimed to assess the potential of CT colonography (CTC) and MR colonography (MRC) in terms of (cost-effectiveness) using the Adenoma and Serrated pathway to Colorectal CAncer model. METHODS: We compared several CTC and MRC strategies with 5- or 10-yearly screening intervals with no screening, 10-yearly colonoscopy screening and biennial faecal immunochemical test (FIT) screening. We assumed trial-based participation rates in the base-case analyses and varied the rates in sensitivity analyses. Incremental lifetime costs and health effects were estimated from a healthcare perspective. RESULTS: The health gain of CTC and MRC was similar and ranged from 0.031 to 0.048 life-year gained compared with no screening, for 2-5 screening rounds. Lifetime costs per person for MRC strategies were €60-110 higher than those for CTC strategies with an equal number of screening rounds. All imaging-based strategies were cost-effective compared with no screening. FIT screening was the dominant screening strategy, leading to most LYG and highest cost-savings. Compared with three rounds of colonoscopy screening, CTC with five rounds was found to be cost-effective in an incremental analysis of imaging strategies. Assumptions on screening participation have a major influence on the ordering of strategies in terms of costs and effects. CONCLUSION: CTC and MRC have potential for CRC screening, compared with no screening and compared with three rounds of 10-yearly colonoscopy screening. When taking FIT screening as the reference, imaging is not cost-effective. Participation is an important driver of effectiveness and cost estimates.
Division: Cancer Research Division
Funding Body: This research was performed within the framework of the Center for Translational Molecular Medicine, project DeCoDe (Grant 03O-101).
DOI: 10.1259/bjr.20150910
ISSN: 1748-880X
Appears in Collections:Research Articles

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