Do men and women need to be screened differently with fecal immunochemical testing? A cost-effectiveness analysis
© 2017 American Association for Cancer Research. Background: Several studies suggest that test characteristics for the fecal immunochemical test (FIT) differ by gender, triggering a debate on whether men and women should be screened differently. We used the microsimulation model MISCAN-Colon to eval...
| Main Authors: | , , , , , , , , |
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| Format: | Conference Paper |
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2017
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| Online Access: | http://hdl.handle.net/20.500.11937/56935 |
| _version_ | 1848759973857722368 |
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| author | Van Der Meulen, M. Kapidzic, A. Van Leerdam, M. Van Der Steen, A. Kuipers, E. Spaander, M. De Koning, H. Hol, L. Lansdorp_Vogelaar, Iris |
| author_facet | Van Der Meulen, M. Kapidzic, A. Van Leerdam, M. Van Der Steen, A. Kuipers, E. Spaander, M. De Koning, H. Hol, L. Lansdorp_Vogelaar, Iris |
| author_sort | Van Der Meulen, M. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 2017 American Association for Cancer Research. Background: Several studies suggest that test characteristics for the fecal immunochemical test (FIT) differ by gender, triggering a debate on whether men and women should be screened differently. We used the microsimulation model MISCAN-Colon to evaluate whether screening stratified by gender is cost-effective. Methods: We estimated gender-specific FIT characteristics based on first-round positivity and detection rates observed in a FIT screening pilot (CORERO-1). Subsequent ly, we used the model to estimate harms, benefits, and costs of 480 genderspecific FIT screening strategies and compared them with uniform screening. Results: Biennial FIT screening from ages 50 to 75 was less effective in women than men [35.7 vs. 49.0 quality-adjusted life years (QALY) gained, respectively] at higher costs (€42, 161 vs. -€5, 471, respectively). However, the incremental QALYs gained and costs of annual screening compared with biennial screening were more similar for both genders (8.7 QALYs gained and €26, 394 for women vs. 6.7 QALYs gained and €20, 863 for men). Considering all evaluated screening strategies, optimal gender-based screening yielded at most 7% more QALYs gained than optimal uniform screening and even resulted in equal costs and QALYs gained from a willingness- to-pay threshold of €1, 300. Conclusions: FIT screening is less effective in women, but the incremental cost-effectiveness is similar in men and women. Consequently, screening stratified by gender is not more costeffective than uniform FIT screening. Impact: Our conclusions support the current policy of uniform FIT screening. Cancer Epidemiol Biomarkers Prev; 26(8); 1328-36. |
| first_indexed | 2025-11-14T10:08:24Z |
| format | Conference Paper |
| id | curtin-20.500.11937-56935 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:08:24Z |
| publishDate | 2017 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-569352017-09-27T10:48:51Z Do men and women need to be screened differently with fecal immunochemical testing? A cost-effectiveness analysis Van Der Meulen, M. Kapidzic, A. Van Leerdam, M. Van Der Steen, A. Kuipers, E. Spaander, M. De Koning, H. Hol, L. Lansdorp_Vogelaar, Iris © 2017 American Association for Cancer Research. Background: Several studies suggest that test characteristics for the fecal immunochemical test (FIT) differ by gender, triggering a debate on whether men and women should be screened differently. We used the microsimulation model MISCAN-Colon to evaluate whether screening stratified by gender is cost-effective. Methods: We estimated gender-specific FIT characteristics based on first-round positivity and detection rates observed in a FIT screening pilot (CORERO-1). Subsequent ly, we used the model to estimate harms, benefits, and costs of 480 genderspecific FIT screening strategies and compared them with uniform screening. Results: Biennial FIT screening from ages 50 to 75 was less effective in women than men [35.7 vs. 49.0 quality-adjusted life years (QALY) gained, respectively] at higher costs (€42, 161 vs. -€5, 471, respectively). However, the incremental QALYs gained and costs of annual screening compared with biennial screening were more similar for both genders (8.7 QALYs gained and €26, 394 for women vs. 6.7 QALYs gained and €20, 863 for men). Considering all evaluated screening strategies, optimal gender-based screening yielded at most 7% more QALYs gained than optimal uniform screening and even resulted in equal costs and QALYs gained from a willingness- to-pay threshold of €1, 300. Conclusions: FIT screening is less effective in women, but the incremental cost-effectiveness is similar in men and women. Consequently, screening stratified by gender is not more costeffective than uniform FIT screening. Impact: Our conclusions support the current policy of uniform FIT screening. Cancer Epidemiol Biomarkers Prev; 26(8); 1328-36. 2017 Conference Paper http://hdl.handle.net/20.500.11937/56935 10.1158/1055-9965.EPI-16-0786 restricted |
| spellingShingle | Van Der Meulen, M. Kapidzic, A. Van Leerdam, M. Van Der Steen, A. Kuipers, E. Spaander, M. De Koning, H. Hol, L. Lansdorp_Vogelaar, Iris Do men and women need to be screened differently with fecal immunochemical testing? A cost-effectiveness analysis |
| title | Do men and women need to be screened differently with fecal immunochemical testing? A cost-effectiveness analysis |
| title_full | Do men and women need to be screened differently with fecal immunochemical testing? A cost-effectiveness analysis |
| title_fullStr | Do men and women need to be screened differently with fecal immunochemical testing? A cost-effectiveness analysis |
| title_full_unstemmed | Do men and women need to be screened differently with fecal immunochemical testing? A cost-effectiveness analysis |
| title_short | Do men and women need to be screened differently with fecal immunochemical testing? A cost-effectiveness analysis |
| title_sort | do men and women need to be screened differently with fecal immunochemical testing? a cost-effectiveness analysis |
| url | http://hdl.handle.net/20.500.11937/56935 |