POTENTIAL COSTS OF FLEXIBLE SIGMOIDOSCOPY-BASED COLORECTAL-CANCER SCREENING

Background & Aims: Increasing evidence shows that periodic screening b y flexible sigmoidoscopy with appropriate referral of patients with ad enomas to colonoscopy could substantially decrease colorectal cancer m ortality rates. Estimates of the complete cost of such screening are n eeded. The aim of this study was to estimate the annual costs of perio dic screening of Americans 50 years and older by flexible sigmoidoscop y with referral of subjects with adenomas to colonoscopy, Methods: Cos t analysis of flexible sigmoidoscopy, followed by colonoscopy as warra nted, in U.S. population cohorts reaching age 50 each year from 1995 t o 2010 was performed. Total yearly costs of repeat screening and surve illance examinations at American Cancer Society-recommended and other intervals were determined. Results: With screening and surveillance in tervals of 3 years, annual costs for the cohort of individuals turning 50 in 1995 would increase to $553 million by 2010, Annual costs for t he entire population 50 years of age and older could increase by 2010 to nearly $20 billion, Conclusions: The cost of flexible sigmoidoscopy -based screening for colorectal cancer could vary as much as threefold depending on the protocol chosen.