TITLE

Option appraisal of population-based colorectal cancer screening programmes in England

AUTHOR(S)
Tappenden, Paul; Chilcott, James; Eggington, Simon; Patnick, Julietta; Sakai, Hannah; Karnon, Jonathon
PUB. DATE
May 2007
SOURCE
Gut;May2007, Vol. 56 Issue 5, p677
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objectives: To estimate the effectiveness, cost-effectiveness and resource impact of faecal occult blood testing (FOBT) and flexible sigmoidoscopy (FSIG) screening options for colorectal cancer to inform the Department of Health's policy on bowel cancer screening in England. Methods: We developed a state transition model to simulate the life experience of a cohort of individuals without polyps or cancer through to the development of adenomatous polyps and malignant carcinoma and subsequent death in the general population of England. The costs, effects and resource impact of five screening options were evaluated: (a) FOBT for individuals aged 50-69 (biennial screening); (b) FOBT far individuals aged 60–69 (biennial screening); (c) once-only FSIG far individuals aged 55; (d) once-only FSIG for individuals aged 60; and (e) once-only FSIG for individuals aged 60, fallowed by FOBT for individuals aged 61–70 (biennial screening). Results: The model suggests that screening using FSIG with or without FOBT may be cost-saving and may produce additional benefits compared with a policy of no screening. The marginal cost-effectiveness of FOBT options compared to a policy of no screening is estimated to be below £3000 per quality adjusted life year gained. Conclusions: Screening using FOBT and/or FSIG is potentially a cost-effective strategy for the early detection of colorectal cancer. However, the practical feasibility of alternative screening programmes is inevitably limited by current pressures on endoscopy services.
ACCESSION #
25298733

 

Related Articles

  • Colorectal Cancer in Russian-Speaking Jewish Emigrés: Community-Based Screening. Vadlamani, Lalit; Maher, James F.; Shaete, Mona; Smirnoff, Alex; Cameron, Daniel G.; Winkelmann, John C.; Goldberg, Stephen J. // American Journal of Gastroenterology;Sep2001, Vol. 96 Issue 9, p2755 

    OBJECTIVES: Colorectal cancer (CRC) screening by fecal occult blood testing and flexible sigmoidoscopy is recommended by many authorities for those older than age 50. Ashkenazi Jews have been shown to have a higher level of CRC and polyps than the general population. A subset of Ashkenazi Jews,...

  • The Case for Direct Colonoscopy Screening for Colorectal Cancer. Bond, John H. // American Journal of Gastroenterology;Feb2006, Vol. 101 Issue 2, p263 

    Recent large series of direct colonoscopy screening for colorectal cancer increase our understanding of the advantages of this approach, and have indirectly confirmed efficacy. When performed by well-trained, experienced endoscopists, colonoscopy screening is successful and safe. The prevalence...

  • Results of a Repeat Television-Advertised Mass Screening Program for Colorectal Cancer using Fecal Occult Blood Tests. McGarrity, Thomas J.; Long, Patricia A.; Peiffer, Laurie P. // American Journal of Gastroenterology;Mar1990, Vol. 85 Issue 3, p266 

    The results of a 1987 television-advertised colorectal screening program using fecal occult blood tests (FOBF) are compared with the initial 1986 program (results in parentheses). In the 1987 program, 73,508 fecal occult blood test (FOBT) kits were distributed free of charge, of which 63% were...

  • Screening for Colorectal Cancer—Which Strategy is the Best? Church, Timothy R. // JNCI: Journal of the National Cancer Institute;Sep2011, Vol. 103 Issue 17, p1282 

    The article reviews research studies on the most effective screening method for colorectal cancer (CRC). Literature review reveals that given the comparability of screening outcomes of flexible sigmoidoscopy, colonoscopy and fecal occult blood test (FOBT), cost effectiveness analyses of the...

  • Colon Pathology Detected After a Positive Screening Flexible Sigmoidoscopy: A Prospective Study in an Ethnically Diverse Cohort. Francois, Fritz; Park, James; Bini, Edmund J. // American Journal of Gastroenterology;Apr2006, Vol. 101 Issue 4, p823 

    OBJECTIVES: Although the association between distal neoplasia on sigmoidoscopy and proximal colonic pathology on follow-up colonoscopy has been well-described, it is not known if these findings are consistent across ethnic groups. The aim of this study was to evaluate ethnic variations in the...

  • Predictors of colorectal cancer screening in diverse primary care practices. Zimmerman, Richard K.; Nowalk, Mary Patricia; Tabbarah, Melissa; Grufferman, Seymour // BMC Health Services Research;2006, Vol. 6, p116 

    Background: To explain why rates of colorectal cancer (CRC) screening including fecal occult blood testing (FOBT), flexible sigmoidoscopy (FS), colonoscopy (CS), and barium enema (BE), are low, this study assessed determinants of CRC screening from medical records. Methods: Data were abstracted...

  • Screening for colorectal cancer. Austoker, Joan // BMJ: British Medical Journal (International Edition);8/6/94, Vol. 309 Issue 6951, p382 

    Focusses on colorectal cancer and efficacy of screening in Great Britain. Epidemiology of colorectal cancer; Consideration of faecal occult blood test as screening procedure; Comparison between sigmoidoscopy and faecal occult blood tests. INSETS: Box 1--Faecal occult blood tests as screening...

  • THE EFFECT OF ANTICOAGULANT MEDICATION ON FALSE POSITIVE RATES IN FAECAL OCCULT BLOOD TESTING. Clarke, P. D.; Leslie, A.; Jack, F.; Steel, R. J. C. // Gut;Apr2004 Supplement 3, Vol. 53, pA67 

    The article presents a study to elicit whether anticoagulant medication can affect the false positive rate of fecal occult blood (FOB) testing. The data for the study were obtained from the colorectal cancer pilot screening programme conducted on Tayside (Scotland) in 50-69 year olds. 846...

  • Effect of faecal occult blood testing on colorectal cancer mortality in the surveillance of subjects at moderate risk of colorectal neoplasia: a case-control study. Lamah, M.; Norris, J.; Caffarey, S. M.; Broughton, M.; Marks, C. G. // International Journal of Colorectal Disease;Sep2001, Vol. 16 Issue 5, p313 

    Colonoscopy is the established method of surveillance of subjects at high risk of developing colorectal neoplasia. Its role in the surveillance of a population at moderate risk is less clear, however, as the procedure is expensive, time consuming and occasionally hazardous. The aim of this study...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics