Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-22T18:12:57.710Z Has data issue: false hasContentIssue false
  • English
  • Français

COST-EFFECTIVENESS OF AN ADVANCE NOTIFICATION LETTER TO INCREASE COLORECTAL CANCER SCREENING

Published online by Cambridge University Press:  19 June 2013

Paula Cronin ,
Stephen Goodall ,
Trevor Lockett ,
Christine M. O'Keefe ,
Richard Norman  and
Jody Church
Paula Cronin
Affiliation:
Centre for Health Economics Research and Evaluation, Faculty of Business, University of Technology Sydney
Stephen Goodall
Affiliation:
Centre for Health Economics Research and Evaluation, Faculty of Business, University of Technology Sydney
Trevor Lockett
Affiliation:
Preventative Health National Research Flagship, CSIRO Food and Nutritional Science
Christine M. O'Keefe
Affiliation:
CSIRO Mathematics, Informatics and Statistics
Richard Norman
Affiliation:
Centre for Health Economics Research and Evaluation, Faculty of Business, University of Technology Sydney
Jody Church
Affiliation:
Centre for Health Economics Research and Evaluation, Faculty of Business, University of Technology Sydney
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The aim of this study is to evaluate the cost-effectiveness of a patient-direct mailed advance notification letter on participants of a National Bowel Cancer Screening Program (NBCSP) in Australia, which was launched in August 2006 and offers free fecal occult blood testing to all Australians turning 50, 55, or 65 years of age in any given year.

Methods: This study followed a hypothetical cohort of 50-year-old, 55-year-old, and 65-year-old patients undergoing fecal occult blood test (FOBT) screening through a decision analytic Markov model. The intervention compared two strategies: (i) advance letter, NBCSP, and FOBT compared with (ii) NBCSP and FOBT. The main outcome measures were life-years gained (LYG), quality-adjusted life-years (QALYs) gained and incremental cost-effectiveness ratio.

Results: An advance notification screening letter would yield an additional 54 per 100,000 colorectal cancer deaths avoided compared with no letter. The estimated cost-effectiveness was $3,976 per LYG and $6,976 per QALY gained.

Conclusions: An advance notification letter in the NBCSP may have a significant impact on LYG and cancer deaths avoided. It is cost-effective and offers a feasible strategy that could be rolled out across other screening program at an acceptable cost.

Keywords

Cost-effectiveness analysisScreeningColorectal cancer
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 29 , Issue 3 , July 2013 , pp. 261 - 268
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.United States Cancer Statistics Working Group. U.S. cancer statistics: 2004 incidence and mortality. Atlanta, GA: U.S. Department of Health and Human Services; 2007.Google Scholar
2.Australian Institute of Health and Welfare & Australian Association of Cancer Registries. Cancer in Australia: An overview, 2008. Cancer series no. 46. Cat. no. CAN 42. Canberra: Australian Institute of Health and Welfare; 2008.Google Scholar
3.Mandel, JS, Church, TR, Bond, JH, et al.The effect of fecel occult-blood screening on the incidence of colorectal cancer. N Engl J Med. 2000;343:1603–1607.CrossRefGoogle Scholar
4.Salkeld, G, Young, G, Irwig, L, Haas, M, Glasziou, P. Cost-effectiveness analysis of screening by faecal occult blood testing for colorectal cancer in Australia. Aust N Z J Public Health. 1996;20:138–143.CrossRefGoogle ScholarPubMed
5.Tappenden, P, Eggington, S, Nixon, R, et al.Colorectal cancer screening options appraisal: Cost-effectiveness, cost-utility and resource impact of alternative screening options for colorectal cancer. Report to the English Bowel Cancer Screening Working Group. Sheffield: School of Health and Related Research, University of Sheffield; 2004.Google Scholar
6.Bishop, J, Glass, P, Tracey, E, et al.Health economics review of bowel cancer screening in Australia. Cancer Institute NSW; 2008.Google Scholar
7.Australian Goverment Department of Health and Ageing. Australia's Bowel Cancer Screening Pilot and beyond: Final evaluation report. Screening Monograph No. 6. Canberra: Australian Goverment Department of Health and Ageing; 2005.Google Scholar
8.Cole, SR, Smith, A, Wilson, C, et al.An advance notification letter increases participation in colorectal cancer screening. J Med Screen. 2007;14:73–75.CrossRefGoogle ScholarPubMed
9.Lee, JK, Groessl, EJ, Ganiats, TG, Ho, SB. Cost-effectiveness of a mailed educational reminder to increase colorectal cancer screening. BMC Gastroenterol. 2011;11:93.CrossRefGoogle ScholarPubMed
10.Sequist, TD, Franz, C, Ayanian, JZ. Cost-effectiveness of patient mailings to promote colorectal cancer screening. Med Care. 2010;48:553–557.CrossRefGoogle ScholarPubMed
11.O'Leary, BA, Olynyk, JK, Neville, AM, Platell, CF. Cost-effectiveness of colorectal cancer screening: Comparison of community-based flexible sigmoidoscopy with fecal occult blood testing and colonoscopy. J Gastroenterol Hepatol. 2004;19:38–47.CrossRefGoogle ScholarPubMed
12.Collett, JA, Olynyk, JK, Platell, CF. Flexible sigmoidoscopy screening for colorectal cancer in average-risk people: Update of a community-based project. Med J Aust. 2000;173:463–466.CrossRefGoogle ScholarPubMed
13.Lieberman, DA, Weiss, DG, Bond, JH, et al.Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380. N Engl J Med. 2000;343:162–168.CrossRefGoogle Scholar
14.Bell, J, and New South Wales Department of Health, and N.S.W. Cancer Council Cancer Epidemiology Research Unit. Colorectal cancer in NSW in 1972 to 1993. Sydney: Cancer Epidemiology Research Unit, NSW Cancer Council; 1996.Google Scholar
15.Mapp, TJ, Hardcastle, JD, Moss, SM, Robinson, MH. Survival of patients with colorectal cancer diagnosed in a randomized controlled trial of faecal occult blood screening. Br J Surg. 1999;86:1286–1291.CrossRefGoogle Scholar
16.Robinson, MH, Hardcastle, JD, Moss, SM, et al.The risks of screening: Data from the Nottingham randomised controlled trial of faecal occult blood screening for colorectal cancer. Gut. 1999;45:588–592.CrossRefGoogle ScholarPubMed
17.American Cancer Society. Detailed guide: Colon and rectum cancer: How is colorectal cancer staged? Atlanta, GA: American Cancer Society; 2009.Google Scholar
18.Australian Government Department of Health and Ageing. Medicare benefits schedule book. Canbarra: Australian Government Department of Health and Ageing; 2010.Google Scholar
19.Loeve, F, Brown, ML, Boer, R, et al.Endoscopic colorectal cancer screening: A cost-saving analysis. J Natl Cancer Inst. 2000;92:557–563.CrossRefGoogle ScholarPubMed
20.Brenner, H, Altenhofen, L, Katalinic, A, Lansdorp-Vogelaar, I, Hoffmeister, M. Sojourn time of preclinical colorectal cancer by sex and age: Estimates from the German National Screening Colonoscopy Database. Am J Epidemiol. 2011;174:1140–1146.CrossRefGoogle ScholarPubMed
21.Petitti, D.Meta-analysis, decision analysis, and cost-effectivness analysis: Methods for quantitative synthesis in medicine. 2nd ed.New York: Oxford University Press; 2000.Google Scholar
22.Parker, MA, Robinson, MH, Scholefield, JH, Hardcastle, JD. Psychiatric morbidity and screening for colorectal cancer. J Med Screen. 2002;9:7–10.CrossRefGoogle ScholarPubMed
23.Australian Bureau of Statistics. Australian demographic statistics. Canberra: ABS; 2006.Google Scholar
24.InSure®. Fecal immunochemical test immunoassay for human hemoglobin in stool. Product Instructions. Edison, NJ: Enterix; 2009.Google Scholar
25.Smith, A, Young, GP, Cole, SR, & Bampton, P. Comparison of a brush-sampling fecal immunochemical test for hemoglobin with a sensitive guaiac-based fecal occult blood test in detection of colorectal neoplasia. Cancer. 2006;107:2152–2159.CrossRefGoogle ScholarPubMed
26.Australian Bureau of Statistics. Consumer price index. Canberra: ABS; 2009.Google Scholar
27.Briggs, A, Claxton, K, Mculpher, M. Decision modelling for health economic evaluation. 2nd ed. New York: Oxford University Press; 2007.Google Scholar
28.George, B, Harris, A, Mitchell, A. Cost-effectiveness analysis and the consistency of decision making: Evidence from pharmaceutical reimbursement in Australia (1991 to 1996). Pharmacoeconomics. 2001;19:1103–1109.CrossRefGoogle ScholarPubMed
29.Lane, JM, Chow, E, Young, GP, Good, N. Immunochemical testing in a colonoscopic surveillance program speeds detection of colorectal neoplasia. Gastroenterology. 2010;139:1918–1926.CrossRefGoogle Scholar
30.Howard, K, Salkeld, G, Irwig, L, Adelstein, BA. High participation rates are not necessary for cost-effective colorectal cancer screening. J Med Screen. 2005;12:96–102.CrossRefGoogle Scholar
31.King, J, Fairbrother, G, Thompson, C, Morris, DL. Colorectal cancer screening: Optimal compliance with postal faecal occult blood test. Aust N Z J Surg. 1992;62:714–719.CrossRefGoogle ScholarPubMed
32.Chirikos, TN, Chistman, LK, Seft Hunter, BS, Roetzheim, MD. Cost-effectiveness of an intervention to increase cancer screening in primary care settings. Prev Med. 2004;39:230–238.CrossRefGoogle ScholarPubMed
33.Atkin, WS, Morson, BC, Cuzick, J. Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med. 1992;326:658–662.CrossRefGoogle ScholarPubMed
34.Australian Institute of Health and Welfare. Health system expenditures on cancer and other neoplasms in Australia, 2000–01. Canberra: Australian Institute of Health and Welfare; 2005.Google Scholar
35.Australian Goverment Department of Health and Ageing. National hospital costs data collection cost report round 14. Canberra: Australian Goverment Department of Health and Ageing; 2010.Google Scholar
36.Tracey, E, Alam, N, Chen, W, Bishop, J. Cancer in New South Wales: Incidence and Mortality 2006. Sydney: Cancer Institute NSW; 2008.Google Scholar
37.Smith, A, Young, GP, Cole, SR, Bampton, P. Comparison of a brush-sampling fecal immunochemical test for hemoglobin with a sensitive guaiac-based fecal occult blood test in detection of colorectal neoplasia. Cancer. 2006;107:2152–2159.CrossRefGoogle ScholarPubMed
38.National Health and Medical Research Council & Australian Cancer Network. Clinical practice guidelines for the prevention, diagnosis and management of colorectal cancer. Canberra: The Cancer Council Australia and Australian Cancer Network; 2005.Google Scholar
39.National Bowel Cancer Screening Program (Australia) & Australian Institute of Health and Welfare. National bowel cancer screening program monitoring report 2008. Cancer series 49. Cat. no. 45. Canberra: Australian Institute of Health and Welfare; 2009.Google Scholar
40.McLeish, JA, Thursfield, VJ, Giles, GG. Survival from colorectal cancer in Victoria: 10-year follow up of the 1987 management survey. ANZ J Surg. 2002;72:352–356.CrossRefGoogle ScholarPubMed
Supplementary material: File

Cronin Supplementary Material

Appendix

Download Cronin Supplementary Material(File)
File 201.2 KB