Cost-effectiveness of one versus two sample faecal immunochemical testing for colorectal cancer screening
MetadataShow full item record
Objective The sensitivity and specificity of a single faecal immunochemical test (FIT) are limited. The performance of FIT screening can be improved by increasing the screening frequency or by providing more than one sample in each screening round. This study aimed to evaluate if two-sample FIT screening is cost-effective compared with one-sample FIT. Design The MISCANecolon microsimulation model was used to estimate costs and benefits of strategies with either one or two-sample FIT screening. The FIT cut-off level varied between 50 and 200 ng haemoglobin/ml, and the screening schedule was varied with respect to age range and interval. In addition, different definitions for positivity of the two-sample FIT were considered: at least one positive sample, two positive samples, or the mean of both samples being positive. Results Within an exemplary screening strategy, biennial FIT from the age of 55-75 years, one-sample FIT provided 76.0-97.0 life-years gained (LYG) per 1000 individuals, at a cost of $259000-264000 (range reflects different FIT cut-off levels). Two-sample FIT screening with at least one sample being positive provided 7.3-12.4 additional LYG compared with one-sample FIT at an extra cost of $50000-59 000. However, when all screening intervals and age ranges were considered, intensifying screening with one-sample FIT provided equal or more LYG at lower costs compared with two-sample FIT. Conclusion If attendance to screening does not differ between strategies it is recommended to increase the number of screening rounds with one-sample FIT screening, before considering increasing the number of FIT samples provided per screening round.
Showing items related by title, author, creator and subject.
First trimester screening cut-offs for noninvasive prenatal testing as a contingent screen: Balancing detection and screen-positive rates for trisomy 21Maxwell, Susannah; James, I.; Dickinson, J.; O'Leary, Peter (2016)© 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Objective: To provide data on how screen-positive and detection rates of first trimester prenatal screening for fetal Down syndrome ...
Rabeneck, L.; Lansdorp_Vogelaar, Iris (2015)Several Asian countries are implementing nationwide cancer screening programs. Assessment of the effectiveness of these programs is critical to their success as this is the only way to ensure that the benefits of screening ...
Lee, Crystal; Colagiuri, S. (2016)Globally, 382 million adults aged 20-79 years are estimated to have diabetes and 46% are unaware of their condition. Another 316 million adults are at increased risk of developing diabetes. Although there are suggestions ...