Colorectal cancer screening in Italy: feasibility and cost effectiveness in a model area

Citation
D. Sorrentino et al., Colorectal cancer screening in Italy: feasibility and cost effectiveness in a model area, EUR J GASTR, 11(6), 1999, pp. 655-660
Citations number
28
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
ISSN journal
0954691X → ACNP
Volume
11
Issue
6
Year of publication
1999
Pages
655 - 660
Database
ISI
SICI code
0954-691X(199906)11:6<655:CCSIIF>2.0.ZU;2-H
Abstract
Objective. To evaluate the feasibility and cost-effectiveness of screening programmes for colorectal cancer in Italy. Design. We compared five types of programmes: annual faecal occult blood te sting, sigmoidoscopy (every 5 years), faecal occult blood testing plus sigm oidoscopy (every 1 and 5 years), colonoscopy (every 10 years) (all in the a ge group 55-69 years, last examination at 70 years) and 'filter' colonoscop y. The latter had to be performed in persons at 50 years of age and repeate d every 10 years until the age of 70, Costs for the tests and colon cancer care were paid by the Regional Health Office to the hospitals performing th e procedures/treatments. Setting. Data were applied to a small model area in northern Italy (Gemona, 80000 inhabitants) with well-known demographic (age distribution) and epid emiological (colon cancer incidence) features. Results. All-inclusive 10-year costs per screenee and per death prevented ( in US dollars) were: 965 and 77200 for faecal occult blood testing; 436 and 15500 for sigmoidoscopy; 1521 and 35000 for sigmoidoscopy plus faecal occu lt blood testing; 510 and 15100 for colonoscopy; 510 and 14000 for 'filter' colonoscopy. With 'filter' colonoscopy the programme required 870 colonosc opies per year, while with colonoscopy 13700 colonoscopies were needed at t ime zero. Conclusions. In Italy, screening programmes based on sigmoidoscopy/colonosc opy are more cost effective than those based on faecal occult blood testing ,'filter' colonoscopy at age 50 appears superior to the other types of endo scopy-based screening programmes because it utilizes, at any point in time, a much smaller fraction of available resources, Eur J Gastroenterol Hepato l 11:655-660. (C) 1999 Lippincott Williams & Wilkins.