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- W2995015073 abstract "Organized screening for Colorectal Cancer (CRC) has been set up in 2009 in France. Individuals aged 50 to 74y with medium risk for CRC (i.e. no familial history (FH), inflammatory bowel disease (IBD) or Lynch syndrome/Familial Adenomatous Polyposis (FAP)) are eligible. Current screening is based on fecal occult blood testing (FOBT) with an immunological test (iFOBT). This study assesses the cost effectiveness of the current screening program compared to alternative tests. A microsimulation model of CRC screening was constructed, calibrated and validated for the French context. The model simulates the natural history of CRC, from adenomas to CRC and includes a screening module. The model was used to compare iFOBT with blood testing, Stool DNA test (sDNA), primary colonoscopy, sigmoidoscopy, virtual colonoscopy and Colon Capsule Endoscopy. Test efficacy was based on literature and costs on French prices. Assumptions were made for participation rate, with a rate of 29.1% (=current participation) every 2 years for FOBT, 65% for blood testing, and 25% for endoscopies (every 10 years). A simulation of 4,000,000 individuals aged 50-74y at model initiation and representative of the French population was used. Compared to the iFOBT, sDNA and blood testing were associated with a reduction in both CRC incidence (-6% and 0%) and mortality (-7% and -16%). Endoscopies were associated with a reduction in CRC incidence (3% to 5%) with an increase in mortality (3% to 4%). All strategies were associated with an increase in screening costs with a 4-fold and 6-fold increase for sDNA and blood testing compared to iFOBT. Cost-effectiveness analysis showed that iFOBT and blood testing were associated with ICERs of €3,609/QALY vs no screening and €154,621/QALY vs FIT. Other strategies were dominated. The results support the use of iFOBT as the current screening test in France for average risk individuals." @default.
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- W2995015073 date "2019-11-01" @default.
- W2995015073 modified "2023-10-17" @default.
- W2995015073 title "PCN172 COST-EFFECTIVENESS OF CRC FRENCH SCREENING PROGRAMME FOR AVERAGE RISK INDIVIDUALS" @default.
- W2995015073 doi "https://doi.org/10.1016/j.jval.2019.09.368" @default.
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