Prevention, screening and treatment of colorectal cancer: a global and regional generalized cost effectiveness analysis

• Main Authors: Johns Benjamin P, Lauer Jeremy A, Lim Stephen S, Ginsberg Gary M, Sepulveda Cecilia R
• Format: Article
• Language: English
• Published: BMC 2010-03-01
• Series: Cost Effectiveness and Resource Allocation
• Online Access: http://www.resource-allocation.com/content/8/1/2

<p>Abstract</p> <p>Background</p> <p>Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented.</p> <p>Methods</p> <p>Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs.</p> <p>Results</p> <p>In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others.</p> <p>In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario) would not be cost effective.</p> <p>In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment.</p> <p>Conclusions</p> <p>From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage.</p>