Starting Colorectal Cancer Screening at Age 45 Years Is Cost-Effective
FRIDAY, March 29, 2019 -- Starting colorectal cancer (CRC) screening at age 45 instead of 50 years seems cost-effective, but greater benefits could be achieved by increasing participation rates for unscreened older individuals, according to a study published online March 28 in Gastroenterology.
Uri Ladabaum, M.D., from the Stanford University School of Medicine in California, and colleagues estimated the cost-effectiveness and national effects of adopting the American Cancer Society recommendation for initiating CRC screening at age 45 instead of 50 years.
The researchers found that initiation of screening colonoscopy at age 45 instead of 50 years would avert four CRCs and two CRC deaths per 1,000 individuals and would yield 14 quality-adjusted life years (QALY) gained, cost $33,900 per QALY gained, and require an additional 758 colonoscopies. Using these 758 colonoscopies to instead screen 231 currently unscreened 55-year-olds or 342 currently unscreened 65-year-olds through age 75 years would result in 13 to 14 CRC cases being averted, six to seven CRC deaths being averted, and 27 to 28 discounted QALYs gained, while saving $163,700 to $445,800. Greater benefits and savings were generated by improving colonoscopy completion rates after abnormal results from a fecal immunochemical test.
"Research to determine the yield of average-risk CRC screening beginning at age 45 and its impact on screening participation at older ages will be invaluable to inform future practice guidelines," the authors write.
One author disclosed financial ties to the pharmaceutical and medical device industries.
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Posted: March 2019