Cost-effectiveness analysis of a quantitative immunochemical test for colorectal cancer screening
Background & Aims: Two European randomized trials (N = 30,000) compared guaiac fecal occult blood testing with quantitative fecal immunochemical testing (FIT) and showed better attendance rates and test characteristics for FIT. We aimed to identify the most cost-effective FIT cutoff level for re...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
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W.B. Saunders Co.
2011
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| Online Access: | http://hdl.handle.net/20.500.11937/49861 |
| _version_ | 1848758333716037632 |
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| author | Wilschut, J. Hol, L. Dekker, E. Jansen, J. Van Leerdam, M. Lansdorp_Vogelaar, Iris Kuipers, E. Habbema, J. Van Ballegooijen, M. |
| author_facet | Wilschut, J. Hol, L. Dekker, E. Jansen, J. Van Leerdam, M. Lansdorp_Vogelaar, Iris Kuipers, E. Habbema, J. Van Ballegooijen, M. |
| author_sort | Wilschut, J. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background & Aims: Two European randomized trials (N = 30,000) compared guaiac fecal occult blood testing with quantitative fecal immunochemical testing (FIT) and showed better attendance rates and test characteristics for FIT. We aimed to identify the most cost-effective FIT cutoff level for referral to colonoscopy based on data from these trials and allowing for differences in screening ages. Methods: We used the validated MIcrosimulation SCreening ANalysis (MISCAN)-Colon microsimulation model to estimate costs and effects of different screening strategies for FIT cutoff levels of 50, 75, 100, 150, and 200 ng/mL hemoglobin. For each cutoff level, screening strategies were assessed with various age ranges and screening intervals. We assumed sufficient colonoscopy capacity for all strategies. Results: At all cost levels, FIT screening was most effective with the 50 ng/mL cutoff level. The incremental cost-effectiveness ratio of biennial screening between ages 55 and 75 years using FIT at 50 ng/mL, for example, was 3900 euro per life year gained. Annual screening had an incremental cost-effectiveness ratio of 14,900 euro per life year gained, in combination with a wider age range (between ages 45 and 80 years). In the sensitivity analysis, 50 ng/mL remained the preferred cutoff level. Conclusions: FIT screening is more cost-effective at a cutoff level of 50 ng/mL than at higher cutoff levels. This supports the recommendation to use FIT at a cutoff level of 50 ng/mL, which is considerably lower than the values used in current practice. © 2011 AGA Institute. |
| first_indexed | 2025-11-14T09:42:20Z |
| format | Journal Article |
| id | curtin-20.500.11937-49861 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:42:20Z |
| publishDate | 2011 |
| publisher | W.B. Saunders Co. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-498612017-09-13T15:49:09Z Cost-effectiveness analysis of a quantitative immunochemical test for colorectal cancer screening Wilschut, J. Hol, L. Dekker, E. Jansen, J. Van Leerdam, M. Lansdorp_Vogelaar, Iris Kuipers, E. Habbema, J. Van Ballegooijen, M. Background & Aims: Two European randomized trials (N = 30,000) compared guaiac fecal occult blood testing with quantitative fecal immunochemical testing (FIT) and showed better attendance rates and test characteristics for FIT. We aimed to identify the most cost-effective FIT cutoff level for referral to colonoscopy based on data from these trials and allowing for differences in screening ages. Methods: We used the validated MIcrosimulation SCreening ANalysis (MISCAN)-Colon microsimulation model to estimate costs and effects of different screening strategies for FIT cutoff levels of 50, 75, 100, 150, and 200 ng/mL hemoglobin. For each cutoff level, screening strategies were assessed with various age ranges and screening intervals. We assumed sufficient colonoscopy capacity for all strategies. Results: At all cost levels, FIT screening was most effective with the 50 ng/mL cutoff level. The incremental cost-effectiveness ratio of biennial screening between ages 55 and 75 years using FIT at 50 ng/mL, for example, was 3900 euro per life year gained. Annual screening had an incremental cost-effectiveness ratio of 14,900 euro per life year gained, in combination with a wider age range (between ages 45 and 80 years). In the sensitivity analysis, 50 ng/mL remained the preferred cutoff level. Conclusions: FIT screening is more cost-effective at a cutoff level of 50 ng/mL than at higher cutoff levels. This supports the recommendation to use FIT at a cutoff level of 50 ng/mL, which is considerably lower than the values used in current practice. © 2011 AGA Institute. 2011 Journal Article http://hdl.handle.net/20.500.11937/49861 10.1053/j.gastro.2011.07.020 W.B. Saunders Co. restricted |
| spellingShingle | Wilschut, J. Hol, L. Dekker, E. Jansen, J. Van Leerdam, M. Lansdorp_Vogelaar, Iris Kuipers, E. Habbema, J. Van Ballegooijen, M. Cost-effectiveness analysis of a quantitative immunochemical test for colorectal cancer screening |
| title | Cost-effectiveness analysis of a quantitative immunochemical test for colorectal cancer screening |
| title_full | Cost-effectiveness analysis of a quantitative immunochemical test for colorectal cancer screening |
| title_fullStr | Cost-effectiveness analysis of a quantitative immunochemical test for colorectal cancer screening |
| title_full_unstemmed | Cost-effectiveness analysis of a quantitative immunochemical test for colorectal cancer screening |
| title_short | Cost-effectiveness analysis of a quantitative immunochemical test for colorectal cancer screening |
| title_sort | cost-effectiveness analysis of a quantitative immunochemical test for colorectal cancer screening |
| url | http://hdl.handle.net/20.500.11937/49861 |