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Colonoscopic surveillance - a cost-effective method to prevent hereditary and familial colorectal cancer
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
2017 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 52, no 9, 1002-1007 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Approximately 20-30% of all colorectal cancer (CRC) cases may have a familial contribution. The family history of CRC can be prominent (e.g., hereditary colorectal cancer (HCRC)) or more moderate (e.g., familial colorectal cancer (FCRC)). For family members at risk, colonoscopic surveillance is a well-established method to prevent both HCRC and FCRC, although the evidence for the exact procedures of the surveillance is limited. Surveillance can come at a high price if individuals are frequently examined, as this may result in unnecessary colonoscopies in relation to actual risk for CRC. This study analyses the cost-effectiveness of a surveillance programme implemented in the Northern Sweden Health Care Region.

Methods: The study includes 259 individuals prospectively recorded in the colonoscopic surveillance programme registry at the Cancer Prevention Clinic, Umea University Hospital. We performed a cost-utility analysis with a contrafactual design: we compared observed costs and loss of quality-adjusted life years (QALYs) due to CRC with the surveillance programme to an expected outcome without surveillance. The main measure was the incremental cost-effectiveness ratio (ICER) between surveillance and non-surveillance. Scenario analysis was used to explore uncertainty.

Results: The ICER between surveillance and non-surveillance in the base model was 3596Euro/QALY. The ICER varied from -4620Euro in the best-case scenario to 33,779Euro in the worst-case scenario.

Conclusion: Colonoscopic surveillance is a very cost-effective method to prevent HCRC and FCRC compared to current thresholds for cost-effectiveness and other cancer preventive interventions.

Place, publisher, year, edition, pages
2017. Vol. 52, no 9, 1002-1007 p.
Keyword [en]
Colonic disorders, health economy, endoscopy general
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cancer and Oncology
Identifiers
URN: urn:nbn:se:umu:diva-137901DOI: 10.1080/00365521.2017.1327615ISI: 000404368000013PubMedID: 28587529OAI: oai:DiVA.org:umu-137901DiVA: diva2:1128972
Available from: 2017-07-31 Created: 2017-07-31 Last updated: 2017-07-31Bibliographically approved

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Sjöström, OlleLindholm, LarsMelin, Beatrice
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CiteExportLink to record
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Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
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  • nn-NO
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  • Other locale
More languages
Output format
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  • asciidoc
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