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. 2023 Jan 19;15(3):633.
doi: 10.3390/cancers15030633.

The Use of a Non-Invasive Biomarker for Colorectal Cancer Screening: A Comparative Cost-Effectiveness Modeling Study

Martin C S Wong  1   2 , Junjie Huang  1   2 , Yuet-Yan Wong  1 , Samantha Ko  1 , Victor C W Chan  1 , Siew C Ng  3   4 , Francis K L Chan  3   4
Affiliations

The Use of a Non-Invasive Biomarker for Colorectal Cancer Screening: A Comparative Cost-Effectiveness Modeling Study

Martin C S Wong et al. Cancers (Basel). .

Abstract

This study aimed to examine the cost-effectiveness of fecal biomarker M3 panel compared to fecal immunochemical test (FIT) and colonoscopy in an Asian population. In a hypothetical population of 100,000 persons aged 50 years who received FIT yearly, M3 biomarker yearly, or colonoscopy every 10 years until the age of 75 years. Participants with positive FOBT or a result of "high risk" identified using the M3 biomarker are offered colonoscopy. We assumed surveillance colonoscopy is repeated every 3 years, and examined the treatment cost. A comparison of various outcome measures was conducted using Markov modelling. The incremental cost-effectiveness ratio (ICER) of FIT, M3 biomarker, and colonoscopy was USD108,176, USD133,485 and USD159,596, respectively. Comparing with FIT, the use of M3 biomarker could lead to significantly smaller total loss of cancer-related life-years (2783 vs. 5279); a higher number of CRC cases prevented (1622 vs. 146), a higher proportion of CRC cases prevented (50.2% vs. 4.5%), more life-years saved (2852 vs. 339), and cheaper total costs per life-year saved (USD212,553 vs. 773,894). The total costs per life-year saved is more affordable than that achieved by colonoscopy as a primary screening tool (USD212,553 vs. USD236,909). The findings show that M3 biomarkers may be more cost-effective than colonoscopy.

Keywords: colorectal cancer; cost-effectiveness; fecal immunochemical tests; non-invasive biomarker; screening.

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Conflict of interest statement

The fecal biomarker M3 used in this paper is a product of GenieBiome limited. M.C.S.W. has been serving as an advisory committee member for Pfizer, and an external expert for GlaxoSmithKline Limited. He has been paid consultancy fees for providing advice on research. He is an Honorary Advisor of GenieBiome limited. S.C.N. has served as speakers for Janssen, Abbvie, Takeda, Ferring, Tilotts, Menarini, Pfizer and have received research grants from Olympus, Ferring, Janssen and Abbvie. She is scientific cofounder of GenieBiome limited. F.K.L.C. has served as a consultant to Eisai, Pfizer, Takeda, and Otsuka, and has been paid lecture fees by Eisai, Pfizer, AstraZeneca, and Takeda. The other authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Markov process on strategies using FIT, M3CRC and colonoscopy as primary screening test. They are listed as: (a) FIT/M3CRC; (b) Colonoscopy. CRC: colorectal cancer; FIT: fecal immunochemical tests. The figure described transitions of screening participants to various stages, and the model included annual mortality. Subjects were followed up from 50 to 75 years.
Figure 2
Figure 2
Cost-effectiveness analysis for the screening tests.
Figure 3
Figure 3
One-way sensitivity analysis on the compliance rate of screening tests.
Figure 4
Figure 4
Two-way sensitivity analysis on the sensitivity and specificity of M3CRC.
Figure 5
Figure 5
One-way sensitivity analysis on the cost of colonoscopy.
See this image and copyright information in PMC

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