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 25 May 2018

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News

Modeling future capacity needs in the English bowel cancer screening program

Researchers in the September issue of Gut predict colonoscopy volumes and costs in the English bowel cancer screening program.

News image

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Bowel cancer screening using fecal occult blood testing and colonoscopy is currently being rolled out across England.

Guidelines recommend that people identified as having intermediate- or high-risk bowel polyps be offered surveillance colonoscopy due to their elevated risk of bowel cancer.

In this study, Drs KE Nnoaham and C Lines predict the likely year-on-year increase in volumes and spending on colonoscopy due to the screening and surveillance programs.

Drs Nnoaham and Lines constructed a model based on current screening and surveillance guidelines using screening outcome measures taken from the second round of the English bowel screening pilot.

This was then used to predict colonoscopy volumes and cost for a hypothetical population.

Surveillance would detect 34 cancers at a cost of £394,157.
Gut

For a hypothetical population of 500,000 people, with average deprivation and 66,956 subjects aged 60 to 74 years, the initial screening and surveillance would detect 34 cancers at a cost of £394,157.

They calculated that in the first 8 years, colonoscopy numbers will grow at a rate of 23 per year. Most of these will be surveillance colonoscopies.

Colonoscopy costs may grow by £11 808 yearly in the same period, representing a cost per eligible person of £2.86 initially, increasing by £0.13 every year.

Sensitivity analyses suggest significant changes in these predictions if screening uptake changes by 20%.

Drs Nnoaham and Lines concluded, “The model has been used to make projections for 5 primary care trusts within the South Central Strategic Health Authority”.

“Results from the volume and cost projections can inform service planning and resource allocation at local levels for the implementation of the current and future bowel cancer screening program.”

Gut 2008; 57: 1238-45

08 September 2008

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