Dr Paul Tappenden and colleagues from England estimated the effectiveness, cost-effectiveness and resource impact of fecal occult blood testing.
The investigative team also evaluated flexible sigmoidoscopy screening options for colorectal cancer to inform the Department of Health's policy on bowel cancer screening.
The team developed a state transition model to simulate the life experience of a cohort of individuals.
|Fecal occult blood testing costs below $6000 per quality adjusted life year|
The model simulated individuals without polyps or cancer through to the development of adenomatous polyps and malignant carcinoma, and subsequent death.
The costs, effects and resource impact of 5 screening options were evaluated.
The team evaluated fecal occult blood testing for individuals aged 50 to 69.
Fecal occult blood testing for individuals aged 60 to 69 were assessed.
The team assessed once-only flexible sigmoidoscopy for individuals aged 55, and once-only flexible sigmoidoscopy for individuals aged 60.
In addition, the team evaluated a once-only flexible sigmoidoscopy for individuals aged 60, followed by fecal occult blood testing for individuals aged 61 to 70.
The investigators found that the model suggests that screening using flexible sigmoidoscopy with or without fecal occult blood testing may be cost-saving.
The team noted that it may also produce additional benefits compared with a policy of no screening.
The cost-effectiveness of fecal occult blood testing options vs a policy of no screening is estimated to be below £3000 or $6000 per quality adjusted life year gained.
Dr Tappenden's team concluded, “Screening using fecal occult blood testing and/or flexible sigmoidoscopy is potentially a cost-effective strategy for the early detection of colorectal cancer.”
“However, the practical feasibility of alternative screening programmes is inevitably limited by current pressures on endoscopy services.”