Cost-utility analysis of colonoscopy or faecal immunochemical test for population-based organised colorectal cancer screening

• Type: Article in International Scientific Journal
• Date: 2019

Authors

Areia, M (Author) Other; Fuccio, L (Author) Other; Hassan, C (Author) Other; Dekker, E (Author) Other; Dias Pereira, A (Author) Other; Mario Dinis Ribeiro (Author) FMUP

Journal

Title: United European Gastroenterology Journal

Vol. 7

Pages: 105-113

ISSN: 2050-6406

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 11 Citations

Scopus - 10 Citations

Other information

Authenticus ID: P-00Q-3HV

DOI: 10.1177/2050640618803196

Abstract (EN): Background Organised programmes for colorectal cancer screening demand a high burden of medical and economic resources. The preferred methods are the faecal immunochemical test and primary colonoscopy. Objective The purpose of this study was to perform an economic analysis and comparison between these tests in Europe. Methods We used a Markov cost-utility analysis from a societal perspective comparing biennial faecal immunochemical test or colonoscopy every 10 years screening versus non-screening in Portugal. The population was screened, aged from 50-74 years, and efficacy was evaluated in quality-adjusted life years. For the base-case scenario, the faecal immunochemical test cost was euro3 with 50% acceptance and colonoscopy cost was euro397 with 38% acceptance. The threshold was set at euro39,760/quality-adjusted life years and the primary outcome was the incremental cost-effectiveness ratio. Results Screening by biennial faecal immunochemical test and primary colonoscopy every 10 years resulted in incremental utilities of 0.00151 quality-adjusted life years and 0.00185 quality-adjusted life years at additional costs of euro4 and euro191, respectively. The faecal immunochemical test was the most cost-effective option providing an incremental cost-effectiveness ratio of euro2694/quality-adjusted life years versus euro103,633/quality-adjusted life years for colonoscopy. Colonoscopy capacity would have to increase 1.3% for a faecal immunochemical test programme or 31% for colonoscopy. Conclusion Biennial faecal immunochemical test screening is better than colonoscopy as it is cost-effective, allows more individuals to get screened, and provides a more rational use of the endoscopic capacity available.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9