Cost evaluation in a colorectal cancer screening programme by faecal occult blood test in the District of Florence
| Autor: | Grazia, Grazzini, Stefano, Ciatto, Cesare, Cislaghi, Guido, Castiglione, Manuele, Falcone, Paola, Mantellini, Marco, Zappa, Carmen Beatriz, Visioli |
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| Rok vydání: | 2008 |
| Předmět: |
Adenoma
medicine.medical_specialty Colonoscopy Gastroenterology Indirect costs Predictive Value of Tests Internal medicine Cost evaluation Humans Mass Screening Medicine Aged medicine.diagnostic_test business.industry Health Policy Public Health Environmental and Occupational Health Cancer Faecal occult blood Middle Aged medicine.disease Italy Colorectal cancer screening Occult Blood Predictive value of tests Patient Compliance Faecal occult blood test Colorectal Neoplasms business |
| Zdroj: | Journal of Medical Screening. 15:175-181 |
| ISSN: | 1475-5793 0969-1413 |
| DOI: | 10.1258/jms.2008.008032 |
| Popis: | Objectives To evaluate the direct costs of first and repeat colorectal cancer screening by immunochemical faecal occult blood testing (I-FOBT). Methods Florence district residents aged 50–70 were invited to undergo one-time I-FOBT every two years. Full colonoscopy was recommended for FOBT-positive subjects. Direct cost analysis was carried out separately for the first and repeat screening. All relevant resources consumed by the programme were calculated. Results Among 25,428 or 62,369 subjects invited to the first or repeat screening, respectively, the corresponding participation rate was 47.8% or 52.3%, and the positivity rate was 4.4% and 3.3%. Corresponding detection rates and positive predictive values for cancer and advanced adenoma were 11.3% or 8.9% and 32.4% or 32.8%, respectively. The assessment phase accounted for the major cost, as compared with recruitment and screening. All cost indicators were slightly higher in the first screening compared with repeat screening. Cost per cancer and advanced adenoma detected was similar in the first or repeat screening. A higher than observed participation rate would have substantially reduced screening cost. Conclusion Analysis of I-FOBT-organized population-based screening cost demonstrates lower cost at repeat compared with first screening and provides reference for decision-making in screening implementation. |
| Databáze: | OpenAIRE |
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