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  1. Article ; Online: Effectiveness and Cost-Effectiveness of Colorectal Cancer Screening With a Blood Test That Meets the Centers for Medicare & Medicaid Services Coverage Decision.

    van den Puttelaar, Rosita / Nascimento de Lima, Pedro / Knudsen, Amy B / Rutter, Carolyn M / Kuntz, Karen M / de Jonge, Lucie / Escudero, Fernando Alarid / Lieberman, David / Zauber, Ann G / Hahn, Anne I / Inadomi, John M / Lansdorp-Vogelaar, Iris

    Gastroenterology

    2024  

    Abstract: Background & aims: A blood-based colorectal cancer (CRC) screening test may increase screening participation. However, blood tests may be less effective than current guideline-endorsed options. The Centers for Medicare & Medicaid Services (CMS) covers ... ...

    Abstract Background & aims: A blood-based colorectal cancer (CRC) screening test may increase screening participation. However, blood tests may be less effective than current guideline-endorsed options. The Centers for Medicare & Medicaid Services (CMS) covers blood tests with sensitivity of at least 74% for detection of CRC and specificity of at least 90%. In this study, we investigate whether a blood test that meets these criteria is cost-effective.
    Methods: Three microsimulation models for CRC (MISCAN-Colon, CRC-SPIN, and SimCRC) were used to estimate the effectiveness and cost-effectiveness of triennial blood-based screening (from ages 45 to 75 years) compared to no screening, annual fecal immunochemical testing (FIT), triennial stool DNA testing combined with an FIT assay, and colonoscopy screening every 10 years. The CMS coverage criteria were used as performance characteristics of the hypothetical blood test. We varied screening ages, test performance characteristics, and screening uptake in a sensitivity analysis.
    Results: Without screening, the models predicted 77-88 CRC cases and 32-36 CRC deaths per 1000 individuals, costing $5.3-$5.8 million. Compared to no screening, blood-based screening was cost-effective, with an additional cost of $25,600-$43,700 per quality-adjusted life-year gained (QALYG). However, compared to FIT, triennial stool DNA testing combined with FIT, and colonoscopy, blood-based screening was not cost-effective, with both a decrease in QALYG and an increase in costs. FIT remained more effective (+5-24 QALYG) and less costly (-$3.2 to -$3.5 million) than blood-based screening even when uptake of blood-based screening was 20 percentage points higher than uptake of FIT.
    Conclusion: Even with higher screening uptake, triennial blood-based screening, with the CMS-specified minimum performance sensitivity of 74% and specificity of 90%, was not projected to be cost-effective compared with established strategies for colorectal cancer screening.
    Language English
    Publishing date 2024-03-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2024.02.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Cost-effectiveness of prevention and early detection of gastric cancer in Western countries.

    Lansdorp-Vogelaar, Iris / Meester, Reinier G S / Laszkowska, Monika / Escudero, Fernando Alarid / Ward, Zachary J / Yeh, Jennifer M

    Best practice & research. Clinical gastroenterology

    2021  Volume 50-51, Page(s) 101735

    Abstract: Gastric cancer (GC) is a significant global health problem, with Helicobacter pylori infection estimated to be responsible for 89% of non-cardiac GC cases, or 78% of all GC cases. The International Agency for Research on Cancer has called for ... ...

    Abstract Gastric cancer (GC) is a significant global health problem, with Helicobacter pylori infection estimated to be responsible for 89% of non-cardiac GC cases, or 78% of all GC cases. The International Agency for Research on Cancer has called for Helicobacter pylori test-and-treat strategies in countries with high rates of GC. However, for countries with low rates of GC, such as most Western countries, the balance between benefits, harms and costs of screening is less clear-cut. GC is a disease with a well-characterized precancerous process, providing the basis for primary and secondary prevention efforts. However, rigorous data assessing the impact of such interventions in Western countries are lacking. In the absence of clinical trials, modelling offers a unique approach to evaluate the potential impact of various screening and surveillance interventions. In this paper, we provide an overview of modelling studies evaluating the cost-effectiveness of GC screening and surveillance in Western countries.
    MeSH term(s) Cost-Benefit Analysis ; Early Detection of Cancer/methods ; Humans ; Mass Screening/economics ; Mass Screening/methods ; Stomach Neoplasms/diagnosis ; Stomach Neoplasms/economics ; Stomach Neoplasms/epidemiology ; Stomach Neoplasms/prevention & control
    Language English
    Publishing date 2021-02-22
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2048181-0
    ISSN 1532-1916 ; 1521-6918
    ISSN (online) 1532-1916
    ISSN 1521-6918
    DOI 10.1016/j.bpg.2021.101735
    Database MEDical Literature Analysis and Retrieval System OnLINE

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