Colon Cancer Screening Saves More Money

With the increasing expense of treating colorectal cancer, treatment cost savings in the near future will more than double when screening prevents colon and rectal cancers or finds them early.

Looking at expense for an entire population, all screening methods except colonoscopy cost less than treating those cancers that developed, and the net cost of colonoscopy screening fell from over $1,300 to less than $300 per individual in the population.

Iris Lansdorp-Vogelaar, Ph.D in the Netherlands and her team used a computer simulation model to project the average lifetime cost of current colorectal cancer screening methods per person versus the lifetime costs per person to treat colorectal cancer.  Their analyses looked at costs in the past, present, and near future.

They took into account both the more expensive chemotherapy used today and reduced rates of colorectal cancer due to increased screening.

Average lifetime treatment savings versus costs of screening per individual for different screening methods were:

  • Annual Hemoccult II guaiac FOBT:  $1398 (treatment savings) vs $859 (costs of screening)
  • Annual immunochemical fecal testing: $1756 vs $1565
  • Sigmoidoscopy every 5 years: $1706 vs $1575
  • Sigmoidoscopy and Hemoccult II combined strategy: $1931 vs $1878

Screening colonoscopy every ten years didn’t save money overall, but the total net costs fell from $1,317 to $296.

The model had some limitations which may have led to underestimation of treatment costs.  Therapies other than chemotherapy were not included.  At the same time the model assumed that all patients, including the elderly with other serious health conditions, would receive the new chemotherapies.

Dr. Lansdorp-Vogelaar and her team wrote,

The increasingly costly management of colorectal cancer will approximately double the treatment savings from screening … screening is not only desirable from the perspective of governments and insurance companies to reduce colorectal cancer incidence and mortality, but in addition will also help to contain the increasing costs for the management of colorectal cancer.

They concluded,

With the increase in chemotherapy costs for advanced colorectal cancer, most colorectal cancer screening strategies have become cost saving. As a consequence, screening is a desirable approach not only to reduce colorectal cancer incidence and mortality but also to control the costs of colorectal cancer treatment.

SOURCE: Lansdorp-Vogelaar et al., Journal of the National Cancer Institute, Volume 101, Number 20, October 2009.

A Memo to the Media in the JNCI provides more information.

Comments

  1. Kate Murphy says

    C3 strongly recommends that all people assess their individual risks for colorectal cancer and plan a screening program with their doctors.

    While adults at average risk can begin screening at age 50, people with a family history of polyps or colorectal cancer may need to begin earlier and have colonoscopies more often.

    In addition, people with ulcerative colitis or Crohn’s disease should be examined regularly, beginning 8 to 10 years after their diagnosis.

    And people with symptoms of colorectal cancer at any age should have them evaluated, preferably with colonoscopy.

    Although red meat, heavy alcohol use, and smoking increase risk for colorectal cancer, there is no evidence that earlier screening is necessary for people who have these risk factors. Discuss them with your doctor.

    See the C3 Patient Information Prevention section for more information about assessing risk and deciding on a personal screening program.

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