Background: A nationwide colorectal cancer (CRC) screening program was set up in France from 2009 for average-risk, asymptomatic people aged 50-74 years based on an immunochemical fecal occult blood test [faecal immunochemical test (FIT)] every 2 years, followed by colonoscopy if positive. The European standard recommends a participation rate of 45% for the program to be cost-effective, yet the latest published rate in France was 34%. The objective of this study was to compare the cost effectiveness of screening alternatives taking real-world participation rates into account.

Methods: Eight screening strategies were compared, based either on a screening test (Guaiac or FIT testing, blood-based, stool DNA, computed tomography colonography, colon capsules, and sigmoidoscopy) followed by full colonoscopy if positive or direct colonoscopy. A microsimulation model was used to estimate the cost effectiveness associated with each strategy.

Results: Compared with no screening, FIT was associated with a 14.0 quality-adjusted life year (QALY) increase of €50,520 per 1000 individuals, giving an incremental cost-effectiveness ratio (ICER) of €3600/QALY. Only stool DNA and blood-based testing were associated with a QALY increase compared with FIT, with stool DNA weakly dominated by blood-based testing, and the latter associated with an ICER of €154,600/QALY compared with FIT. All other strategies were dominated by FIT.

Conclusion: FIT every 2 years appears to be the most cost-effective CRC screening strategy when taking into account a real-world participation rate of 34%.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509710PMC
http://dx.doi.org/10.1177/1756284820953364DOI Listing

Publication Analysis

Top Keywords

stool dna
12
screening
8
screening strategies
8
screening program
8
crc screening
8
colonoscopy positive
8
participation rate
8
cost effectiveness
8
real-world participation
8
qaly increase
8

Similar Publications

Albendazole/ivermectin combination therapy is a promising alternative to benzimidazole monotherapy alone for Trichuris trichiura control. We used fecal DNA metabarcoding to genetically characterize Trichuris spp. populations in patient samples from Côte d'Ivoire showing lower (egg reduction rate <70%) albendazole/ivermectin sensitivity than those from Laos and Tanzania (egg reduction rates >98%).

View Article and Find Full Text PDF

Background: The effects of antibiotic use on children's gut microbiomes and resistomes are not well characterized in middle-income countries, where pediatric antibiotic consumption is exceptionally common. We characterized the effects of antibiotics commonly used by Peruvian children (i.e.

View Article and Find Full Text PDF

[Follow-up study on screening for early colorectal cancer in Shipai, Dongguan City, China].

Zhonghua Wei Chang Wai Ke Za Zhi

December 2024

Department of Gastrointestinal Endoscopy, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou510655, China Biomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-sen University,Guangzhou510655, China.

To examine follow-up data of different subgroups in order to further evaluate the performance and practical value of community colorectal cancer screening by detection of stool methylation syndecan-2 gene (m) among residents of Shipai Town, Dongguan City. This was an observational study. From May 2021 to February 2022, the Shipai Town government of Dongguan City completed screening for colorectal cancer by detection of stool m in 10,708 residents from 18 villages who had met the initial screening criteria and been selected using whole population sampling.

View Article and Find Full Text PDF

Background: Whereas restoration of fecal consistency after treatment with clioquinol for chronic diarrhea and free fecal water syndrome has been attributed to its antiprotozoal properties, actions of clioquinol on the colonic bacterial microbiota have not been investigated.

Objectives: Characterize the dynamics of fecal microbial diversity before, during, and after PO administration of clioquinol to healthy horses.

Study Design: Experimental prospective cohort study using a single horse group.

View Article and Find Full Text PDF

Obesity is associated with changes in the gut microbiota, as well as with increased permeability of the intestinal wall. In 130 non-obese volunteers, 57 patients with metabolically healthy obesity (MHO), and 76 patients with metabolically unhealthy obesity (MUHO), bacterial DNA was isolated from stool samples, and the 16S rRNA gene was sequenced. The metabolic profile of the microbiota predicted by PICRUSt2 (https://huttenhower.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!