Cost-effectiveness of population-based screening for colorectal cancer: A comparison of guaiac-based faecal occult blood testing, faecal immunochemical testing and flexible sigmoidoscopy

British Journal of Cancer

Volumn 106, Issue 5, 2012, Pages 805-816

  Sharp, L ^a   Tilson, L ^b   Whyte, S ^c   O'Ceilleachair, A ^a   Walsh, C ^b,d   Usher, C ^b   Tappenden, P ^c   Chilcott, J ^c   Staines, A ^e   Barry, M ^b   Comber, H ^a  

^a NATIONAL CANCER REGISTRY IRELAND   (Ireland)

^b ST JAMES S HOSPITAL   (Ireland)

^c UNIVERSITY OF SHEFFIELD   (United Kingdom)

^d TRINITY COLLEGE DUBLIN   (Ireland)

^e DUBLIN CITY UNIVERSITY   (Ireland)

Author keywords

colorectal cancer; cost effectiveness; faecal immunochemical test; flexible sigmoidoscopy; FOBT; mass screening

Indexed keywords

GUAIAC;

ADULT; AGED; ARTICLE; CANCER INCIDENCE; CANCER MORTALITY; CANCER PATIENT; CANCER SCREENING; COLONOSCOPY; COLORECTAL CANCER; COST EFFECTIVENESS ANALYSIS; COST OF ILLNESS; HUMAN; IMMUNOCHEMISTRY; INTERMETHOD COMPARISON; IRELAND; OCCULT BLOOD TEST; POLICY; POPULATION RESEARCH; PRIORITY JOURNAL; QUALITY ADJUSTED LIFE YEAR; SIGMOIDOSCOPY;

AGED; COLORECTAL NEOPLASMS; COST-BENEFIT ANALYSIS; EARLY DETECTION OF CANCER; FECES; FEMALE; GUAIAC; HUMANS; IRELAND; MALE; MASS SCREENING; MIDDLE AGED; OCCULT BLOOD; SIGMOIDOSCOPY;

EID: 84857782204     PISSN: 00070920     EISSN: 15321827     Source Type: Journal    
DOI: 10.1038/bjc.2011.580     Document Type: Article

References (83)

1. Alexander F, Weller D (2003) Evaluation of the UK colorectal cancer screening pilot. Final report by the UK CRC Screening Pilot Evaluation Team. University of Edinburgh: Edinburgh
2. Allison JE, Feldman R, Tekawa IS (1990) Hemoccult screening in detecting colorectal neoplasm: sensitivity, specificity, and predictive value. Longterm follow-up in a large group practice setting. Ann Intern Med 112: 328-333 (Pubitemid 20083607)
3. Allison JE, Sakoda LC, Levin TR, Tucker JP, Tekawa IS, Cuff T, Pauly MP, Shlager L, Palitz AM, Zhao WK, Schwartz JS, Ransohoff DF, Selby JV (2007) Screening for colorectal neoplasms with new fecal occult blood tests: update on performance characteristics. J Natl Cancer Inst 99: 1462-1470
4. Allison JE, Tekawa IS, Ransom LJ, Adrain AL (1996) A comparison of fecal occult-blood tests for colorectal-cancer screening. N Engl J Med 334: 155-159 (Pubitemid 26017953)
5. Atkin WS, Edwards R, Kralj-Hans I, Wooldrage K, Hart AR, Northover JM, Parkin DM, Wardle J, Duffy SW, Cuzick J (2010) Once-only flexible sigmoidoscopy screening in the prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet 375: 1624-1633
6. Atkin WS, Saunders BP (2002) Surveillance guidelines after removal of colorectal adenomatous polyps. Gut 51(Suppl 5): v6-v9 (Pubitemid 35222897)
7. Berchi C, Guittet L, Bouvier V, Launoy G (2010) Cost-effectiveness analysis of the optimal threshold of an automated immunochemical test for colorectal cancer screening: performances of immunochemical colorectal cancer screening. Int J Technol Assess Health Care 26: 48-53
8. Bressler B, Paszat LF, Chen Z, Rothwell DM, Vinden C, Rabeneck L (2007) Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis. Gastroenterol 132: 96-102 (Pubitemid 46108740)
9. Brevinge H, Lindholm E, Buntzen S, Kewenter J (1997) Screening for colorectal neoplasia with faecal occult blood testing compared with flexible sigmoidoscopy directly in a 55-56 years' old population. Int J Colorect Dis 12: 291-295 (Pubitemid 27478332)
10. Burch JA, Soares-Weiser K, St John DJ, Duffy S, Smith S, Kleijnen J, Westwood M (2007) Diagnostic accuracy of faecal occult blood tests used in screening for colorectal cancer: a systematic review. J Med Screen 14: 132-137 (Pubitemid 47511122)
11. Castiglione G, Grazzini G, Poli A, Bonardi R, Ciatto S (1991) Hemoccult sensitivity estimate in a screening program for colorectal cancer in the Province of Florence. Tumori 77: 243-245
12. Chen K, Jiao DA, Zheng S, Zhou S, Yu H (1997) Diagnostic value of fecal occult blood testing for screening colorectal cancer. China Natl J New Gastroenterol 3: 166-168
13. Cheng TI, Wong JM, Hong CF, Cheng SH, Cheng TJ, Shieh MJ, Lin YM, Tso CY, Huang AT (2002) Colorectal cancer screening in asymptomaic adults: comparison of colonoscopy, sigmoidoscopy and fecal occult blood tests. J Formos Med Assoc 101: 685-690 (Pubitemid 36032755)
14. Claxton K, Paulden M, Gravelle H, Brouwer W, Culyer AJ (2011) Discounting and decision making in the economic evaluation of health-care technologies. Health Econ 20: 2-15
15. Cole SR, Young GP (2001) Effect of dietary restriction on participation in faecal occult blood test screening for colorectal cancer. Med J Aust 175: 195-198 (Pubitemid 32791339)
16. Collins JF, Lieberman DA, Durbin TE, Weiss DG (2005) Accuracy of screening for fecal occult blood on a single stool sample obtained by digital rectal examination: a comparison with recommended sampling practice. Ann Intern Med 142: 81-85
17. Cotton PB, Durkalski VL, Pineau BC, Palesch YY, Mauldin PD, Hoffman B, Vining DJ, Small WC, Affronti J, Rex D, Kopecky KK, Ackerman S, Burdick JS, Brewington C, Turner MA, Zfass A, Wright AR, Iyer RB, Lynch P, Sivak MV, Butler H (2004) Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. J Am Med Assoc 291: 1713-1719 (Pubitemid 38489893)
18. Council of the European Union (2003) Council recommendation of 2 December 2003 on cancer screening (2003/878/EC). Official Journal of the European Union: L327-34
19. Dafnis G, Ekbom A, Pahlman L, Blomqvist P (2001) Complications of diagnostic and therapeutic colonoscopy within a defined population in Sweden. Gastrointest Endosc 54: 302-309 (Pubitemid 33665508)
20. Deutekom M, van Rossum LG, van Rijn AF, Laheij RJ, Fockens P, Bossuyt PM, Dekker E, Jansen JB (2010) Comparison of guaiac and immunological fecal occult blood tests in colorectal cancer screening: the patient perspective. Scand J Gastroenterol 45: 1345-1349
21. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. International Agency for Research on Cancer. Lyon: France, Available from: http://globocan.iarc.fr [accessed 29th June 2011]
22. Foley DP, Dunne P, Dervan PJ, Callaghan TW, Crowe J, Lennon JR (1992) Left-sided colonoscopy and haemoccult screening for colorectal neoplasia. Eur J Gastroenterol 4: 925-936
23. Fraser CG, Mathew CM, Mowat NA, Wilson JA, Carey FA, Steele RJ (2007) Evaluation of a card collection-based faecal immunochemical test in screening for colorectal cancer using a two-tier reflex approach. Gut 56: 1415-1418 (Pubitemid 47517837)
24. Fraser CG, Matthew CM, McKay K, Carey FA, Steele RJ (2008) Automated immunochemical quantitation of haemoglobin in faeces collected on cards for screening for colorectal cancer. Gut 57: 1256-1260
25. Fraser CG, Matthew CM, Mowat NA, Wilson JA, Carey FA, Steele RJ (2006) Immunochemical testing of individuals positive for guaiac faecal occult blood test in a screening programme for colorectal cancer: an observational study. Lancet Oncol 7: 127-131 (Pubitemid 43159498)
26. Fryback DG, Lawrence WF (1997) Dollars may not buy as many QALYs as we think: a problem with defining quality-of-life adjustments. Med Decis Making 17: 276-284 (Pubitemid 27282028)
27. Gatto NM, Frucht H, Sundararajan V, Jacobson JS, Grann VR, Neugut AI (2003) Risk of perforation after colonoscopy and sigmoidoscopy: a population-based study. J Natl Cancer Inst 95: 230-236 (Pubitemid 36240636)
28. Gondal G, Grotmol T, Hofstad B, Bretthauer M, Eide TJ, Hoff G (2003) The Norwegian colorectal cancer prevention (NORCCAP) screening study: baseline findings and implementations for clinical work-up in age groups 50-64 years. Scand J Gastroenterol 38: 635-642 (Pubitemid 36724043)
29. Halligan S, Altman DG, Taylor SA, Mallett S, Deeks JJ, Bartram CI, Atkin W (2005) CT colonography in the detection of colorectal polyps and cancer: systematic review, meta-analysis, and proposed minimum data set for study level reporting. Radiology 237: 893-904 (Pubitemid 41636379)
30. Hassan C, Benamouzig R, Spada C, Ponchon T, Zullo A, Suarin JC, Costamagna G (2011) Cost-effectiveness and projected national impact of colorectal cancer screening. Endoscopy 43: 780-789
31. Health Information and Quality Authority (HIQA) (2009) Health Technology Assessment (HTA) of a population-based colorectal cancer screening programme in Ireland. HIQA: Cork
32. Hewitson P, Glasziou P, Irwig L, Towler B, Watson E (2007) Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Cochrane Database Syst Rev, (1): CD001216
33. Hoff G, Grotmol T, Skovlund E, Bretthauer M (2009) Risk of colorectal cancer seven years after flexible sigmoidoscopy screening: a randomised controlled trial. BMJ 338: b1846
34. Hol L, van Leerdam ME, van Ballegooijen M, van Vuuren AJ, van Dekken H, Reijerink JC, van der Togt AC, Habbema JD, Kuipers EJ (2010) Screening for colorectal cancer: randomized trial comparing guaiac-based and immunochemical faecal occult blood testing and flexible sigmoidoscopy. Gut 59: 62-68
35. Hol L, Wilschut JA, van Ballegooijen M, van Vuuren AJ, van der Valk H, Reijerink JC, van der Togt AC, Kuipers EJ, Habbema JD, van Leerdam ME (2009) Screening for colorectal cancer: random comparison of guaiac and immunochemical faecal occult blood testing at different cut-off levels. Br J Cancer 100: 1103-1110
36. Itoh M, Takahashi K, Nishida H, Sakagami K, Okubo T (1996) Estimation of the optimal cut off point in a new immunological faecal occult blood test in a corporate colorectal cancer screening programme. J Med Screen 3: 66-71 (Pubitemid 126736078)
37. Jass JR, Young PJ, Robinson EM (1992) Predictors of presence, multiplicity, size and dysplasia of colorectal adenomas. A necropsy study in New Zealand. Gut 33: 1508-1514
38. Johnson CD, Chen MH, Toledano AY, Heiken JP, Dachman A, Kuo MD, Menias CO, Siewert B, Cheema JI, Obregon RG, Fidler JL, Zimmerman P, Horton KM, Coakley K, Iyer RB, Hara AK, Halvorsen Jr RA, Casola G, Yee J, Herman BA, Burgart LJ, Limburg PJ (2008) Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med 359: 1207-1217
39. Kis RK (2010) National colorectal cancer screening program in the Republic of Croatia-experiences, outcomes and obstacles in the program implementation in the Medimurje County. Acta Med Croatica 64: 363-374
40. Lansdorp-Vogelaar I, van Ballegooijen M, Zauber AG, Habbema JD, Kuipers EJ (2009) Effect of rising chemotherapy costs on the cost savings of colorectal cancer screening. J Natl Cancer Inst 102: 1412-1422
41. Lansdorp-Vogelaar I, Knudsen AB, Brenner H (2010) Cost-effectiveness of colorectal cancer screening-an overview. Best Pract Res Clin Gastroenterol 24: 439-449
42. Lejeune C, Dancourt V, Arveux P, Bonithon-Kopp C, Faivre J (2010) Costeffectiveness of screening for colorectal cancer in France using a guaiac test versus an immunochemical test. Int J Technol Assess Health Care 26: 40-47
43. Levi Z, Birkenfeld S, Vilkin A, Bar-Chana M, Lifshitz I, Chared M, Maoz E, Niv Y (2011) A higher detection rate for colorectal cancer and advanced adenomatous polyp for screening with immunochemical fecal occult blood test than guaiac fecal occult blood test, despite lower compliance rate. A prospective, controlled, feasibility study. Int J Cancer 128: 2415-2424
44. Levin B, Lieberman DA, McFarland B, Andrews KS, Brooks D, Bond J, Dash C, Giardiello FM, Glick S, Johnson D, Johnson CD, Levin TR, Pickhardt PJ, Rex DK, Smith RA, Thorson A, Winawer SJ (2008) Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterol 134: 1570-1595 (Pubitemid 351615355)
45. Lieberman DA, Weiss DG (2001) One-time screening for colorectal cancer with combined fecal occult-blood testing and examination of the distal colon. N Engl J Med 345: 555-560 (Pubitemid 32772096)
46. Liu HH, Huang TW, Chen HL, Wang TH, Lin JT (2003) Clinicopathologic significance of immunohistochemical fecal occult blood test in subjects receiving bidirectional endoscopy. Hepatogastroenterol 50: 1390-1392 (Pubitemid 37186490)
47. Makinen MJ (2007) Colorectal serrated adenocarcinoma. Histopathol 50: 131-150 (Pubitemid 44953404)
48. McNamara D, Qasim A, Lee N, Condon C, O'Morain C (2011) Round one of the Adelaide and Meath Hospital/Trinity College Colorectal Cancer Screening Programme: programme report and analysis based on established international key performance indices. Ir J Med Sci 180: 549-552
49. Morikawa T, Kato J, Yamaji Y, Wada R, Mitsushima T, Sakaguchi K, Shiratori Y (2007) Sensitivity of immunochemical fecal occult blood test to small colorectal adenomas. Am J Gastroenterol 102: 2259-2264 (Pubitemid 47493843)
50. Morikawa T, Kato J, Yamaji Y, Wada R, Mitsushima T, Shiratori Y (2005) A comparison of the immunochemical fecal occult blood test and total colonoscopy in asymptomatic population. Gastroenterol 129: 422-428 (Pubitemid 41096630)
51. Mulhall BP, Veerappan GR, Jackson JL (2005) Meta-analysis: computed tomographic colonography. Ann Intern Med 142: 635-650 (Pubitemid 40529961)
52. Munkholm P (2003) Review article: the incidence and prevalence of colorectal cancer in inflammatory bowel disease. Aliment Pharmacol Ther 18: 1-5 (Pubitemid 37174709)
53. Nakama H, Fattah AS, Zhang B, Kamijo N, Uehara Y (2000) Association of diverticulosis coli and vascular ectasias and the results of fecal occult blood test. Hepatogastroenterol 47: 1277-1279
54. Nakama H, Zhang B, Fattah AA, Kamijo N, Zhang × (2001) Characteristics of colorectal cancer that produce positive immunochemical occult blood test results on stool obtained by digital rectal examination. Can J Gastroenterol 15: 227-230 (Pubitemid 32496344)
55. Nakazato M, Yamano H, Matsushita H, Sato K, Fujita K, Yamanaka Y, Imai Y (2006) Immunologic fecal occult blood test for colorectal cancer screening. Jap Med Assoc J 49: 203-207 (Pubitemid 44209592)
56. National Cancer Screening Service (2011) Update on Progress on the Implementation of the National Colorectal Cancer Screening Programme. Available at http://www.cancerscreening.ie/colorectal.html [Accessed 29th June 2011]
57. Niv Y, Lev-El M, Fraser G, Abuksis G, Tamir A (2002) Protective effect of faecal occult blood test screening for colorectal cancer: worse prognosis for screening refusers. Gut 50: 33-37 (Pubitemid 34028300)
58. Omata F, Shintani A, Isozaki M, Masuda K, Fujita Y, Fukui T (2011) Diagnostic performance of quantitative fecal immunochemical test and multivariate prediction model for colorectal neoplasms in asymptomatic individuals. Eur J Gastroenterol Hepatol 23: 1036-1041
59. Pendergrass CJ, Edelstein DL, Hylind LM, Phillips BT, Iacobuzio-Donahue C, Romans K, Griffin CA, Cruz-Correa M, Tersmette AC, Offerhaus GJ, Giardiello FM (2008) Occurrence of colorectal adenomas in younger adults: an epidemiologic necropsy study. Clin Gastroenterol Hepatol 6: 1011-1015
60. Peris M, Espinas JA, Munoz L, Navarro M, Binefa G, Borràs JM (2007) Lessons learnt from a population-based pilot programme for colorectal cancer screening in Catalonia (Spain). J Med Screen 14: 81-86 (Pubitemid 47067762)
61. Ramsey SD, Andersen MR, Etzioni R, Moinpour C, Peacock S, Potosky A, Urban N (2000) Quality of life in survivors of colorectal carcinoma. Cancer 88: 1294-1303 (Pubitemid 30155164)
62. Regula J, Rupinski M, Kraszewska E, Polkowski M, Pachlewski J, Orlowska J, Nowacki MP, Butruk E (2006) Colonoscopy in colorectalcancer screening for detection of advanced neoplasia. N Engl J Med 355: 1863-1872 (Pubitemid 44664644)
63. Rozen P, Liphshitz I, Barchana M (2011) Follow-up of patients undergoing both semiquantitated immunochemical fecal occult blood andcolonoscopy examinations. Eur J Cancer Prev; e-pub ahead of print 27 September 2011; doi: 10.1097/CEJ.0b013e32834c9cc6
64. Rozen P, Ron E, Fireman Z, Hallak A, Grossman A, Baratz M, Rattan J, Gilat T (1987) The relative value of fecal occult blood tests and flexible sigmoidoscopy in screening for large bowel neoplasia. Cancer 60: 2553-2558 (Pubitemid 17157269)
65. Schrag D (2004) The price tag on progress-chemotherapy for colorectal cancer. N Engl J Med 351: 317-319 (Pubitemid 38944397)
66. Segnan N, Armaroli P, Bonelli L, Risio M, Sciallero S, Zappa M, Andreoni B, Arrigoni A, Bisanti L, Casella C, Crosta C, Falcini F, Ferrero F, Giacomin A, Giuliani O, Santarelli A, Visioli CB, Zanetti R, Atkin WS, Senore C (2011) Once-only sigmoidoscopy in colorectal cancer screening: followup findings of the Italian Randomized Controlled Trial-SCORE. J Natl Cancer Inst 103: 1310-1322
67. Sung JJ, Chan FK, Leung WK, Wu JC, Lau JY, Ching J, To KF, Lee YT, Luk YW, Kung NN, Kwok SP, Li MK, Chung SC (2003) Screening for colorectal cancer in Chinese: comparison of fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. Gastroenterol 124: 608-614 (Pubitemid 36268479)
68. Tappenden P, Chilcott J, Eggington S, Patnick J, Sakai H, Karnon J (2007) Option appraisal of population-based colorectal cancer screening programmes in England. Gut 56: 677-684 (Pubitemid 46662935)
69. Tappenden P, Eggington S, Nixon R, Chilcott J, Sakai H, Karnon J (2004) Colorectal cancer screening options appraisal: cost-effectiveness, costutility and resource impact of alternative screening options for colorectal cancer. School of Health & Related Research: Sheffield
70. Telford JJ, Levy AR, Sambrook JC, Zou D, Enns RA (2010) The cost-effectiveness of screening for colorectal cancer. CMAJ 182: 1307-1313
71. Tilson L, Sharp L, Usher C, Walsh C, S W, O'Ceilleachair A, Stuart C, Mehigan B, John Kennedy M, Tappenden P, Chilcott J, Staines A, Comber H, Barry M (2011) Cost of care for colorectal cancer in Ireland: a health care payer perspective. Eur J Health Econ; e-pub ahead of print 3 June 2011; doi: 10.1007/s10198-011-0325-z UK
72. Flexible Sigmoidoscopy Screening Trial Investigators (2002) Single flexible sigmoidoscopy screening to prevent colorectal cancer: baseline findings of a UK multicentre randomised trial. Lancet 359: 1291-1300
73. US Preventive Services Task Force (2008) Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med 149: 627-637
74. van Dam L, Kuipers EJ, van Leerdam ME (2010) Performance improvements of stool-based screening tests. Best Prac Res Clin Gastroenterol 24: 479-492
75. van Rijn JC, Reitsma JB, Stoker J, Bossuyt PM, van Deventer SJ, Dekker E (2006) Polyp miss rate determined by tandem colonoscopy: a systematic review. Am J Gastroenterol 101: 343-350 (Pubitemid 43381678)
76. van Rossum LG, van Rijn AF, Laheij RJ, van Oijen MG, Fockens P, van Krieken HH, Verbeek AL, Jansen JB, Dekker E (2008) Random comparison of guaiac and immunochemical fecal occult blood tests for colorectal cancer in a screening population. Gastroenterol 135: 82-90 (Pubitemid 351899018)
77. van Rossum LG, van Rijn AF, Verbeek AL, van Oijen MG, Laheij RJ, Fockens P, Jansen JB, Adang EM, Dekker E (2011) Colorectal cancer screening comparing no screening, immunochemical and guaiac fecal occult blood tests: a cost-effectiveness analysis. Int J Cancer 128: 1908-1917
78. Weller D, Moss S, Butler P, Campbell C, Coleman D, Melia J, Robertson R (2006) English pilot of bowel cancer screening: an evaluation of the second round. Final report to the Department of Health. University of Edinburgh: Edinburgh
79. Whynes DK, Frew EJ, Edwards R, Atkin WS (2003) Costs of flexible sigmoidoscopy screening for colorectal cancer in the United Kingdom. Int J Technol Assess Health Care 19: 384-395 (Pubitemid 36818681)
80. Whyte S, Walsh C, Chilcott J (2011) Bayesian calibration of a natural history model with application to a population model for colorectal cancer. Med Decis Making 31: 625-541
81. Winawer SJ, Flehinger BJ, Schottenfeld D, Miller DG (1993) Screening for colorectal cancer with faecal occult blood testing and sigmoidoscopy. J Natl Cancer Inst 85: 1311-1318 (Pubitemid 23249723)
82. Wilschut JA, Hol L, Dekker E, Jansen JB, van Leerdam ME, Lansdorp-Vogelaar I, Kuipers EJ, Habbema JD, van Ballegooijen M (2011) Costeffectiveness analysis of a quantitative immunochemical test for colorectal cancer screening. Gastroenterol 141: 1648-1655
83. Zorzi M, Baracco S, Fedato C, Grazzini G, Naldoni C, Sassoli de Biachi P, Senore C, Visioli CB, Cogo C (2010) Screening for colorectal cancer in Italy: 2008 survey. Epidemiol Prev 34(5-6 Suppl 4): 53-72