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Gastrointest Endosc Clin N Am. 2010 Oct;20(4):751-70. doi: 10.1016/j.giec.2010.07.008.

Cost-effectiveness of colonoscopy.

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  • 1Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 East 63rd Street, Room 357, New York, NY 10065, USA.


This article presents a cost-effectiveness analysis of colorectal cancer screening tests that have been recommended by the United States Preventive Services Task Force, American Cancer Society US Multi-Society Task Force on Colorectal Cancer American College of Radiology, or the American College of Gastroenterology. This cost-effectiveness analysis supports a common theme of the 3 guideline groups that there are multiple acceptable colorectal cancer screening strategies (including colonoscopy). The article shows which recommended strategies are also cost-effective given a range of willingness to pay per life-year gained. The set of cost-effective strategies includes tests that primarily detect cancer early (annual sensitive fecal occult blood tests [FOBTs]; either guaiac or fecal immunochemical tests, but not Hemoccult II), as well as those that can prevent colorectal cancer (flexible sigmoidoscopy every 5 years with a frequent sensitive FOBT [but not flexible sigmoidoscopy as a standalone test], and colonoscopy). Computed tomographic colonography was not a cost-effective strategy. Stool DNA testing was not assessed in the analysis for this article.

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