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• W2806378001 abstract "ScHARR has been commissioned by the UK National Screening Committee (NSC) to consider the costeffectivenessand endoscopy capacity requirements of a variety of different screening options incorporatingfaecal immunochemical testing (FIT) and bowel scope (BS) within the Bowel Cancer Screening Programme(BCSP).An existing cost-effectiveness model was used. The model was refined considerably, new data included andmodel validation was undertaken. All FIT thresholds between 20 and 180 µg/ml were modelled. Analyses wereundertaken to determine which screening strategies involving repeated FIT screening and/or bowel scope aremost cost-effective given endoscopy constraints.Note that the conclusions reached are based on optimising cost-effectiveness where effectiveness is measuredin terms of QALYs gained. If the aim was to optimise QALY gains or CRC incidence/mortality reduction thenconclusions would be different.The analysis without endoscopy constraints indicates that the most cost effective screening strategy is the onewhich delivers the most intensive screening. Regardless of capacity constraints the current screeningstrategies (gFOBT 2-yearly 60-74 with or without bowel scope age 55) are dominated by a FIT screeningstrategy (i.e. a FIT strategy exists which is more effective and less expensive).For repeated FIT screening it is recommended that the screening interval is kept to 2-yearly screening.However, increased benefits may be obtained by re-inviting non-attenders after a 1 year interval. The optimalstarting age for a repeated FIT screening strategy is 50 or 51 hence it is suggested that the screening start ageis reduced compared to what is currently used in the BCSP. The optimal upper screening age varies between65 and 74, depending on the capacity constraint used. The optimal FIT threshold depends on the availablecapacity for screening referral colonoscopies. With 50,000 screening referral colonoscopies (current capacity)then we recommend a strategy of 2-yearly, age 51-65, FIT161 (8 screens). With 70,000 screening referralcolonoscopies (current capacity) then we recommend a strategy of: 2-yearly, age 50-70, FIT153 (11 screens). If90,000 screening referral colonoscopies is considered feasible to achieve in the future then we recommend astrategy of 2-yearly, age 50-74, FIT124 (13 screens).In terms of bowel scope screening the model found uncertainty in whether it is cost effective to replace oneFIT screen with a one-off bowel scope at age 58/59. However, a repeated FIT screening strategy requiring125k screening referral colonoscopies annually would be far more effective and cost effective than a one-offbowel scope at age 59. Such strategies could be considered to have equivalent ‘endoscopy capacity’ (assumingthat 10 bowel scopes and 4 screening referral colonoscopies are equivalent ).Hence, if bowel scope capacitycould be used for undertaking screening referral colonoscopies this would result in higher effectiveness andcost-effectiveness." @default.
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• W2806378001 date "2017-09-22" @default.
• W2806378001 modified "2023-09-26" @default.
• W2806378001 title "Optimising Bowel Cancer Screening Phase 1: Optimising the cost effectiveness of repeated FIT screening and screening strategies combining bowel scope and FIT screening" @default.
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