Population screening for colorectal cancer has recently commenced in the United Kingdom, supported by the evidence of a number of randomized trials and pilot studies.
Certain factors are known to influence screening cost-effectiveness, but it remains unclear whether an ageing population might also have an effect.
Dr Macafee and colleagues from the United Kingdom simulated a population-based screening setting using a Markov model.
|Life expectancy was assumed to increase by 3 years per decade|
|British Journal of Cancer|
The research team also assessed the effect of increasing life expectancy on colorectal cancer screening cost-effectiveness.
A Markov model was constructed, using a cohort simulation, to estimate the cost-effectiveness of colorectal cancer screening in an England and Wales population for an early cohort in 2003, and a late cohort in 2033.
The team’s model outcomes were calculated, including screened and non-screened cohorts in 2003 and 2033.
The screened cohort of men and women aged 60 years were offered biennial unhydrated faecal occult blood testing until the age of 69 years.
The researchers found that life expectancy was assumed to increase by 3 years per decade.
There were 407,552 fewer people entering the model in the 2033 model due to a lower birth cohort.
Population screening saw 30,345 fewer colorectal cancer-related deaths over the 50 years of the model.
Screening the 2033 cohort cost £96 million with cost savings of £43 million in terms of detection and treatment, and £28 million in palliative care costs.
After 30 years of follow-up, the team observed that the cost per life year saved was £1544.
An identical screening program in an early cohort saw a cost per life year saved of £1651.
Dr Macafee’s team concluded, “Population screening for colorectal cancer is costly but enables cost savings in certain areas and a considerable reduction in mortality from colorectal cancer.”
“This Markov simulation suggests that the cost-effectiveness of population screening for colorectal cancer in the United Kingdom may actually be improved by rising life expectancies.”