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Review of economic evidence in the prevention and early detection of colorectal cancer

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  • Kim Jeong
  • John Cairns

Abstract

This paper aims to systematically review the cost-effectiveness evidence, and to provide a critical appraisal of the methods used in the model-based economic evaluation of CRC screening and subsequent surveillance. A search strategy was developed to capture relevant evidence published 1999-November 2012. Databases searched were MEDLINE, EMBASE, National Health Service Economic Evaluation (NHS EED), EconLit, and HTA. Full economic evaluations that considered costs and health outcomes of relevant intervention were included. Sixty-eight studies which used either cohort simulation or individual-level simulation were included. Follow-up strategies were mostly embedded in the screening model. Approximately 195 comparisons were made across different modalities; however, strategies modelled were often simplified due to insufficient evidence and comparators chosen insufficiently reflected current practice/recommendations. Studies used up-to-date evidence on the diagnostic test performance combined with outdated information on CRC treatments. Quality of life relating to follow-up surveillance is rare. Quality of life relating to CRC disease states was largely taken from a single study. Some studies omitted to say how identified adenomas or CRC were managed. Besides deterministic sensitivity analysis, probabilistic sensitivity analysis (PSA) was undertaken in some studies, but the distributions used for PSA were rarely reported or justified. The cost-effectiveness of follow-up strategies among people with confirmed adenomas are warranted in aiding evidence-informed decision making in response to the rapidly evolving technologies and rising expectations. Copyright Jeong and Cairns; licensee Springer. 2013

Suggested Citation

  • Kim Jeong & John Cairns, 2013. "Review of economic evidence in the prevention and early detection of colorectal cancer," Health Economics Review, Springer, vol. 3(1), pages 1-10, December.
    • Handle: RePEc:spr:hecrev:v:3:y:2013:i:1:p:1-10:10.1186/2191-1991-3-20
    DOI: 10.1186/2191-1991-3-20
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    2. Pauline Chauvin & Jean-Michel Josselin & Denis Heresbach, 2012. "Incremental net benefit and acceptability of alternative health policies: a case study of mass screening for colorectal cancer," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(3), pages 237-250, June.
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    Cited by:

    1. S Lucas Goede & Linda Rabeneck & Marjolein van Ballegooijen & Ann G Zauber & Lawrence F Paszat & Jeffrey S Hoch & Jean H E Yong & Sonja Kroep & Jill Tinmouth & Iris Lansdorp-Vogelaar, 2017. "Harms, benefits and costs of fecal immunochemical testing versus guaiac fecal occult blood testing for colorectal cancer screening," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-15, March.
    2. Joan Mendivil & Marilena Appierto & Susana Aceituno & Mercè Comas & Montserrat Rué, 2019. "Economic evaluations of screening strategies for the early detection of colorectal cancer in the average-risk population: A systematic literature review," PLOS ONE, Public Library of Science, vol. 14(12), pages 1-18, December.

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