Options for screening for colorectal cancer in the Royal Air Force : a cost-effectiveness evaluation.
This study aims to investigate the design of any programme to introduce FOBTs as part of the RAF's existing schedule of Periodic Medical Examinations and Screenings, and the age groups to be included, rather than the decision as to whether or not it should be commenced.
The analysis therefore examines the cost per cancer detected.
The information required to evaluate subsequent outcomes, such as cost per life-year saved, is not available for the RAF population so speculative extrapolation from other data is not attempted.
The FOBT contribution to the costs is extremely small and the importance of maximising sensitivity and specificity very great.
Hence dietary modification, and using a test or combination of tests with higher sensitivity and/or lower false-positivity, even if much more expensive, would be highly cost-effective, reducing the above costs substantially.
A pilot study is proposed concerning the introduction on selected stations of FOBTs with RAF PMEs/Screenings, from age 40, to determine :
sensitivity and false-positivity rates for single and serial FOBTs, and the predictive value of positive tests, in RAF screenees ;
the annual cost ;
the costs per CRC case, and per CRC-plus-adenoma case, detected ;
possibly, an estimate of the cost per life-year saved ;
and, hence, whether the programme should be extended to all RAF personnel.
This analysis provides information on the costs and consequences of various FOB screening strategies for the RAF and other Services.
Mots-clés Pascal : Tumeur maligne, Côlon, Rectum, Dépistage, Armée, Royaume Uni, Europe, Analyse coût efficacité, Homme, Militaire, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie, Rectum pathologie, Economie santé
Mots-clés Pascal anglais : Malignant tumor, Colon, Rectum, Medical screening, Army, United Kingdom, Europe, Cost efficiency analysis, Human, Military, Digestive diseases, Intestinal disease, Colonic disease, Rectal disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0005896
Code Inist : 002B13B01. Création : 01/03/1996.