Cost-effectiveness comparison in colorectal cancer screening with fecal immunochemical test and colonoscopy between ages and genders
10.3760/cma.j.issn.1007-5232.2017.10.003
- VernacularTitle:不同性别和年龄段人群粪便隐血试验序贯结肠镜筛查结直肠癌的成本效果分析
- Author:
Hanyue DING
1
;
Dong WU
;
Weixun ZHOU
;
Jingnan LI
Author Information
1. 中国医学科学院医学信息研究所
- Keywords:
Malignant tumor;
Colon;
Rectum;
Colonoscopy;
Fecal immunochemical test;
Cost-effectiveness analysis
- From:
Chinese Journal of Digestive Endoscopy
2017;34(10):699-703
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the rational program of colorectal cancer(CRC)screening between ages and genders by using single or repeated fecal immunochemical test(FIT)and colonoscopy. Methods Data of 6 193 patients who underwent opportunistic CRC screening at Peking Union Medical College Hospital were retrospectively analyzed.Patients were divided into four groups:(1)direct colonoscopy;(2)one FIT followed by colonoscopy;(3)two FITs followed by colonoscopy;(4)three FITs followed by colonoscopy.Cost-effectiveness of the four screening procedures was compared between different age groups and genders.Results Ninety-seven(1.6%)patients with CRC and 1 038(16.8%)with colorectal adenoma were detected. In patients younger than 40 years old,1-3 positive FIT strategies were superior to direct colonoscopy. In men aged 40 to 60,one or two positive FITs out of three was more cost-effective than direct colonoscopy,so was one positive FIT out of three in women aged 40 to 60. Direct colonoscopy was the most cost-effective strategy in men older than 60,while one positive FIT out of two was the best screening choice in women older than 60. Conclusion Age and gender are two influential factors for cost-effectiveness of CRC screening. Direct colonoscopy is the most cost-effective screening strategy for men older than 60,but one or more positive FIT followed by colonoscopy is preferred in other age and gender groups.
