Cost of colorectal cancer screening in two tribal health organizations in Alaska

Abstract

Purpose: We conducted a comprehensive assessment of the resources required to undergo colorectal cancer (CRC) screening in two Alaska Native tribal health organizations.

Methods: We evaluated the cost of CRC screening at Maniilaq Association and Bristol Bay Area Health Corporation, and the communities they serve. We developed a tailored data collection tool to gather data from health clinics. We calculated the cost of screening tests and patient costs. We also conducted interviews with clinic representatives to identify contextual factors that can affect cost estimates.

Results: The cost of fecal immunochemical tests and fecal occult blood tests ranged from $53 to $76. The cost of the colonoscopy procedure ranged from $2,600 to $4,066. Travel costs, including per diem, ranged from $1,561 to $1,740. The cost of missed work was estimated to be $1,008 for patients and medical escorts for both communities. The total cost of receiving a colonoscopy, including procedural costs, travel costs, and the cost of missed work, ranged from $5,348 to $6,635.

Conclusion: We found the cost of the screening tests, travel costs and the cost of missed work to undergo CRC screening were higher in Alaska than national averages. Program planning could benefit from accounting for the costs and additional resources needed in Alaska due to the geography of the state and the location of providers and facilities.

Keywords: Alaska public health; Cancer screening; Colorectal cancer; Patient navigation; Program cost.