TY - JOUR
T1 - Prevention, screening and treatment of colorectal cancer
T2 - a global and regional generalized cost effectiveness analysis
AU - Ginsberg, Gary M.
AU - Lim, Stephen S.
AU - Lauer, Jeremy A.
AU - Johns, Benjamin P.
AU - Sepulveda, Cecilia R.
PY - 2010/3/17
Y1 - 2010/3/17
N2 - Background: Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented.Methods: Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs.Results: In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others.In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario) would not be cost effective.In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment.Conclusions: From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage.
AB - Background: Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented.Methods: Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs.Results: In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others.In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario) would not be cost effective.In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment.Conclusions: From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage.
KW - colorectal cancer
KW - fecal occult blood test
KW - treatment scenario
KW - health state valuation
KW - digital rectal exam
UR - http://www.scopus.com/inward/record.url?scp=77952994625&partnerID=8YFLogxK
U2 - 10.1186/1478-7547-8-2
DO - 10.1186/1478-7547-8-2
M3 - Article
AN - SCOPUS:77952994625
VL - 8
JO - Cost Effectiveness and Resource Allocation
JF - Cost Effectiveness and Resource Allocation
M1 - 2
ER -