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Cost Eff Resour Alloc. 2010 Mar 17;8:2. doi: 10.1186/1478-7547-8-2.

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

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1
Costs, Effectiveness, Expenditure and Priority Setting, World Health Organization, Geneva, Switzerland. ginsbergg@moh.health.gov.il

Abstract

BACKGROUND:

Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented.

METHODS:

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.

RESULTS:

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.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.In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment.

CONCLUSIONS:

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.

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