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    Do men and women need to be screened differently with fecal immunochemical testing? A cost-effectiveness analysis

    Access Status
    Fulltext not available
    Authors
    Van Der Meulen, M.
    Kapidzic, A.
    Van Leerdam, M.
    Van Der Steen, A.
    Kuipers, E.
    Spaander, M.
    De Koning, H.
    Hol, L.
    Lansdorp_Vogelaar, Iris
    Date
    2017
    Type
    Conference Paper
    
    Metadata
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    Citation
    Van Der Meulen, M. and Kapidzic, A. and Van Leerdam, M. and Van Der Steen, A. and Kuipers, E. and Spaander, M. and De Koning, H. et al. 2017. Do men and women need to be screened differently with fecal immunochemical testing? A cost-effectiveness analysis, 46th Annual Digestive Disease Week (DDW), pp. 1328-1336.
    Source Title
    Cancer Epidemiology Biomarkers and Prevention
    Source Conference
    46th Annual Digestive Disease Week (DDW)
    DOI
    10.1158/1055-9965.EPI-16-0786
    ISSN
    1055-9965
    School
    Centre for Behavioural Research in Cancer Control
    URI
    http://hdl.handle.net/20.500.11937/56935
    Collection
    • Curtin Research Publications
    Abstract

    © 2017 American Association for Cancer Research. Background: Several studies suggest that test characteristics for the fecal immunochemical test (FIT) differ by gender, triggering a debate on whether men and women should be screened differently. We used the microsimulation model MISCAN-Colon to evaluate whether screening stratified by gender is cost-effective. Methods: We estimated gender-specific FIT characteristics based on first-round positivity and detection rates observed in a FIT screening pilot (CORERO-1). Subsequent ly, we used the model to estimate harms, benefits, and costs of 480 genderspecific FIT screening strategies and compared them with uniform screening. Results: Biennial FIT screening from ages 50 to 75 was less effective in women than men [35.7 vs. 49.0 quality-adjusted life years (QALY) gained, respectively] at higher costs (€42, 161 vs. -€5, 471, respectively). However, the incremental QALYs gained and costs of annual screening compared with biennial screening were more similar for both genders (8.7 QALYs gained and €26, 394 for women vs. 6.7 QALYs gained and €20, 863 for men). Considering all evaluated screening strategies, optimal gender-based screening yielded at most 7% more QALYs gained than optimal uniform screening and even resulted in equal costs and QALYs gained from a willingness- to-pay threshold of €1, 300. Conclusions: FIT screening is less effective in women, but the incremental cost-effectiveness is similar in men and women. Consequently, screening stratified by gender is not more costeffective than uniform FIT screening. Impact: Our conclusions support the current policy of uniform FIT screening. Cancer Epidemiol Biomarkers Prev; 26(8); 1328-36.

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