As the Australian government considers the future of its National Bowel Cancer Screening Program, Australian and US researchers provide compelling evidence of the cost-effectiveness of expanding the national screening program.

Australia has one of the highest colorectal cancer (CRC) mortality rates in the world. Its current screening program (costing about $29 million a year) provides a one-time immunochemical fecal test (iFOBT) for people aged 50, 55, and 65 years. Program funding expires in mid-2011.

A study funded by the Australian government and the US National Cancer Institute, published in the Feb. 21 Medical Journal of Australia, found that expanding the program to screen all 5 million Australians aged 50 -74 years every two years by iFOBT could end up costing only about $50 million more a year, while saving 300 to 500 lives every year.

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Overall, colorectal cancer screening rates were higher in 2008 than in 2006.

By 2008 almost 2 of every 3 Americans over the age of 50 had either had a fecal occult blood test in the past year or sigmoidoscopy or colonoscopy within the past ten years.

Health insurance made a huge different with two-thirds (66.6 percent) of people with insurance up-to-date with screening compared to about one-third (37.5 percent) of those without health insurance. Read the rest of this entry »

If doctors ask  healthy people simple questions about cancers in their families, they can find people who are at increased risk for Lynch syndrome, an inherited condition that greatly increases risk for colorectal and uterine cancer.

Doctors can use a simple set of screening questions available online to pinpoint an individual’s risk before that person ever gets cancer.   The online tool takes less than two minutes to complete.

If family history shows an individual to be at higher risk, genetic testing not only saves lives but is cost-effective.

Once Lynch syndrome is diagnosed, active steps can be taken to prevent Lynch-associated cancers or diagnose them early when they can be cured. Read the rest of this entry »

In a computer simulation, FIT — fecal immunochemical testing — done every year saved more lives and cost the least of any colorectal cancer screening method, including colonoscopy.

The computer model looked at 100,000 average risk people and compared screening methods results for

• number of colorectal cancer cases
• number of colorectal cancer deaths
• cost of screening and treating colorectal cancer for each screened person

Compared to not screening at all, annual FIT  could save 3 out of 4 deaths from colorectal cancer. For every 100,000 people between 50 and 75, nearly 3,500 people wouldn’t get colorectal cancer, and over 1,300 wouldn’t die.

Not only did FIT screening save the most lives, it was the most cost effective.  It saved about $70 (Canadian) in screening and cancer treatment expenses for each person screened, better than any other method. Read the rest of this entry »

Almost half of the colorectal cases in the United States are diagnosed at late-stages of the diseases when treatment is more difficult, according to a new report released today by the Centers for Disease and Control and Prevention (CDC). Significant findings of the study “Surveillance of Screening-Detected Cancers (Colon and Rectum, Breast, and Cervix) — United States, 2004-2006” include:

* Incidence rates of late-stage colorectal cancer increased with age and were highest among black men and women.
* Late-stage colon and rectum incidence rates ranged from 51.0 to 86.5, and were highest in Connecticut, Delaware, Illinois, Iowa, Kentucky, Louisiana, Maine, Nebraska, New Jersey, and Pennsylvania.

“This report causes concern because so many preventable cancers are not being diagnosed when treatment is most effective,” said Marcus Plescia, MD, MPH, Director, Division of Cancer Prevention and Control. “More work is needed to widely implement evidence-based cancer screening tests which may lead to early detection and, ultimately, an increase in the number of lives saved.”

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