The relative efficacy and effectiveness of different colon screening programs has not been assessed.
The purpose of this analysis was to provide a model for comparing several colon screening programs and to determine the key variables that impact program effectiveness.
Five screening programs were compared : annual fecal occult blood test (FOBT) alone, flexible sigmoidoscopy, flexible sigmoidoscopy and FOBT combined, one-time colonoscopy, and air-contrast barium enema.
Key variables were adjusted for sensitivity analyses.
Cost-effectiveness was defined as the cost per cancer death prevented.
FOBT alone prevents fewer cancer deaths than the other programs.
The addition of flexible sigmoidoscopy to the FOBT increases the rate of cancer prevention.
One-time colonoscopy has the greatest impact on colorectal cancer mortality, largely because of assumptions that cancer would be prevented in most patients who undergo polypectomy.
FOBT alone is the most cost-effective of the programs, but the cost is sensitive to several key variables.
The model shows key variables that impact the cost-effectiveness of colon screening programs.
Compliance is an important determinant of effectiveness of all of the screening programs.
Future study should be focused on methods of patient education that improve patient compliance with screening.
Mots-clés Pascal : Carcinome, Côlon, Dépistage, Analyse coût efficacité, Modélisation, Critère performance, Etude comparative, Homme, Etats Unis, Amérique du Nord, Amérique, Tumeur maligne, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie
Mots-clés Pascal anglais : Carcinoma, Colon, Medical screening, Cost efficiency analysis, Modeling, Performance requirement, Comparative study, Human, United States, North America, America, Malignant tumor, Digestive diseases, Intestinal disease, Colonic disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0035040
Code Inist : 002B30A04B. Création : 01/03/1996.