PREVENTION OF COLORECTAL-CANCER - A COST-EFFECTIVENESS APPROACH TO A SCREENING MODEL EMPLOYING SIGMOIDOSCOPY

Background. Today, only carcinoma of the bronchus kills more people th an colorectal cancer (CRC). However, CRC is both preventable and curab le. In Norway, projects aiming to detect adenomas and early cancers by the screening of a population aged about 60 years employing sigmoidos copy have been discussed. Materials and methods: In this study, a math ematical model was used to estimate the cost-effectiveness of a screen ing programme for colorectal polyps followed by polypectomy. A once-on ly sigmoidoscopy at age 60 followed by coloscopy in selected risk grou ps was suggested. Data from the English-language literature, the Natio nal Cancer Registry of Norway, and Statistics Norway were included. No rwegian cost data from the National Health Administration were also us ed. Costs of screening and those related to earlier diagnosis, and sav ings on health care and averted loss in production due to prevented CR Cs were calculated. Results: The basic cost per patient invited and sc reened (70% compliance) in the suggested programme was estimated at po und 81.7 and pound 116.7, respectively When gains due to prevented CRC s were included, the figures became pound 34.5 and pound 49.2. The cos t per life-year saved was calculated as pound 2,889. This strongly ind icates that screening for the early detection and prevention of CRC is one of the most cost-effective programmes in cancer. Conclusions. CRC screening according to the suggested programme appears to be cost-eff ective. Clear evidence that screening can reduce mortality from CRC sh ould convince health-care policy makers that the time has come to enco urage screening for colorectal cancer.