BACKGROUND & AIMS: Colorectal cancer screening beginning at age 50 is recommended for all Americans considered at "average" risk for the development of colorectal cancer. METHODS: We used 1988-1995 California Cancer Registry data to compare the cost-effectiveness of two 35-year colorectal cancer screening interventions among Asians, blacks, Latinos, and Whites. RESULTS: Average annual age-specific colorectal cancer incidence rates were highest in blacks and lowest in Latinos. Screening beginning at age 50 was most cost-effective in blacks and least cost-effective in Latinos (measured as dollars spent per year of life saved), using annual fecal occult blood testing (FOBT) combined with flexible sigmoidoscopy every 5 years and using colonoscopy every 10 years. A 35-year screening program beginning in blacks at age 42, whites at age 44, or Asians at age 46 was more cost-effective than screening Latinos beginning at age 50. CONCLUSIONS: Colorectal cancer screening programs beginning at age 50, using either FOBT and flexible sigmoidoscopy or colonoscopy in each racial or ethnic group, are within the $40,000-$60,000 per year of life saved upper cost limit considered acceptable for preventive strategies. Screening is most cost-effective in blacks because of high age-specific colorectal cancer incidence rates.
BACKGROUND & AIMS:Colorectal cancer screening beginning at age 50 is recommended for all Americans considered at "average" risk for the development of colorectal cancer. METHODS: We used 1988-1995 California Cancer Registry data to compare the cost-effectiveness of two 35-year colorectal cancer screening interventions among Asians, blacks, Latinos, and Whites. RESULTS: Average annual age-specific colorectal cancer incidence rates were highest in blacks and lowest in Latinos. Screening beginning at age 50 was most cost-effective in blacks and least cost-effective in Latinos (measured as dollars spent per year of life saved), using annual fecal occult blood testing (FOBT) combined with flexible sigmoidoscopy every 5 years and using colonoscopy every 10 years. A 35-year screening program beginning in blacks at age 42, whites at age 44, or Asians at age 46 was more cost-effective than screening Latinos beginning at age 50. CONCLUSIONS:Colorectal cancer screening programs beginning at age 50, using either FOBT and flexible sigmoidoscopy or colonoscopy in each racial or ethnic group, are within the $40,000-$60,000 per year of life saved upper cost limit considered acceptable for preventive strategies. Screening is most cost-effective in blacks because of high age-specific colorectal cancer incidence rates.
Authors: Charles E Basch; Randi L Wolf; Corey H Brouse; Celia Shmukler; Alfred Neugut; Lawrence T DeCarlo; Steven Shea Journal: Am J Public Health Date: 2006-10-31 Impact factor: 9.308
Authors: Avishek Kumar; Nihar Shah; Yashpal Modi; Hamid S Shaaban; Joseph DePasquale; Vincent A DeBari; Swaroopa Yerrabothala; Michael Maroules; Gunwant K Guron Journal: Med Oncol Date: 2011-06-28 Impact factor: 3.064
Authors: David A Lieberman; Jennifer L Holub; Matthew D Moravec; Glenn M Eisen; Dawn Peters; Cynthia D Morris Journal: JAMA Date: 2008-09-24 Impact factor: 56.272
Authors: Marc T Kiviniemi; Jennifer L Hay; Aimee S James; Isaac M Lipkus; Helen I Meissner; Michael Stefanek; Jamie L Studts; John F P Bridges; David R Close; Deborah O Erwin; Resa M Jones; Karen Kaiser; Kathryn M Kash; Kimberly M Kelly; Simon J Craddock Lee; Jason Q Purnell; Laura A Siminoff; Susan T Vadaparampil; Catharine Wang Journal: Cancer Epidemiol Biomarkers Prev Date: 2009-11 Impact factor: 4.254