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Review
. 2010 Oct;20(4):751-70.
doi: 10.1016/j.giec.2010.07.008.

Cost-effectiveness of colonoscopy

Ann G Zauber  1
Affiliations
Review

Cost-effectiveness of colonoscopy

Ann G Zauber. Gastrointest Endosc Clin N Am. 2010 Oct.

Abstract

This article presents a cost-effectiveness analysis of colorectal cancer screening tests that have been recommended by the United States Preventive Services Task Force, American Cancer Society US Multi-Society Task Force on Colorectal Cancer American College of Radiology, or the American College of Gastroenterology. This cost-effectiveness analysis supports a common theme of the 3 guideline groups that there are multiple acceptable colorectal cancer screening strategies (including colonoscopy). The article shows which recommended strategies are also cost-effective given a range of willingness to pay per life-year gained. The set of cost-effective strategies includes tests that primarily detect cancer early (annual sensitive fecal occult blood tests [FOBTs]; either guaiac or fecal immunochemical tests, but not Hemoccult II), as well as those that can prevent colorectal cancer (flexible sigmoidoscopy every 5 years with a frequent sensitive FOBT [but not flexible sigmoidoscopy as a standalone test], and colonoscopy). Computed tomographic colonography was not a cost-effective strategy. Stool DNA testing was not assessed in the analysis for this article.

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Conflict of interest statement

Conflict of interest: None.

Figures

Figure 1
Figure 1
Graphical representation of natural history of colorectal cancer as modeled by MISCAN model. Screening provides the opportunity to intervene in the natural history of the adenoma carcinoma sequence. Screening can either remove a precancerous lesion (i.e., adenoma), thus moving a person to the “No lesion” state, or through early cancer detection, which makes an undiagnosed cancer clinically detected at a potentially earlier stage of disease where it is more amenable to treatment.
Figure 2
Figure 2
Cost effectiveness analysis for 14 colorectal cancer screening strategies.
See this image and copyright information in PMC

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