BACKGROUND AND AIMS: As shown previously, 40- to 50-year-old first-degree relatives of patients with colorectal cancer (CRC) have significantly more colorectal adenomas than controls of the same age. Screening colonoscopy of these persons at risk between 40 and 50 years might be cost beneficial. METHODS: We prepared a detailed cost-benefit analysis of screening colonoscopy and possible repeat endoscopies according to current expenditures for endoscopic procedures in Germany. Since screening colonoscopy is generally offered and reimbursed from 55 years on in Germany, we analysed the period between 45 and 55 years, taking an annual interest rate of 5% into account. Costs were analysed based on the results of a former study [11] depending on various participation rates in a general screening programme. FINDINGS: Based on the available 1994 figure of about 20,000 euros for diagnosis and treatment of one cancer case, screening colonoscopy is cost beneficial when participation is high. Under a more realistic assumption of currently about 40,000 euros per cancer case, screening colonoscopy is cost beneficial in any case. INTERPRETATION: Our data support that systematic screening colonoscopy in first-degree relatives of patients with CRC by the age of 45 years most likely demonstrates an economic benefit.
BACKGROUND AND AIMS: As shown previously, 40- to 50-year-old first-degree relatives of patients with colorectal cancer (CRC) have significantly more colorectal adenomas than controls of the same age. Screening colonoscopy of these persons at risk between 40 and 50 years might be cost beneficial. METHODS: We prepared a detailed cost-benefit analysis of screening colonoscopy and possible repeat endoscopies according to current expenditures for endoscopic procedures in Germany. Since screening colonoscopy is generally offered and reimbursed from 55 years on in Germany, we analysed the period between 45 and 55 years, taking an annual interest rate of 5% into account. Costs were analysed based on the results of a former study [11] depending on various participation rates in a general screening programme. FINDINGS: Based on the available 1994 figure of about 20,000 euros for diagnosis and treatment of one cancer case, screening colonoscopy is cost beneficial when participation is high. Under a more realistic assumption of currently about 40,000 euros per cancer case, screening colonoscopy is cost beneficial in any case. INTERPRETATION: Our data support that systematic screening colonoscopy in first-degree relatives of patients with CRC by the age of 45 years most likely demonstrates an economic benefit.
Authors: W Schmiegel; G Adler; P Frühmorgen; U Fölsch; U Graeven; P Layer; S Petrasch; R Porschen; C Pox; T Sauerbruch; H J Schmoll; M Zeitz Journal: Z Gastroenterol Date: 2000-01 Impact factor: 2.000
Authors: Markus Menges; Johannes Fischinger; Barbara Gärtner; Thomas Georg; Dietrich Woerdehoff; Matthias Maier; Matthias Harloff; Christa Stegmaier; Jochen Raedle; Martin Zeitz Journal: Int J Colorectal Dis Date: 2005-09-15 Impact factor: 2.571
Authors: Benjamin Avidan; Amnon Sonnenberg; Thomas G Schnell; Jack Leya; Adrienne Metz; Stephen J Sontag Journal: Am J Gastroenterol Date: 2002-06 Impact factor: 10.864
Authors: S J Winawer; A G Zauber; M N Ho; M J O'Brien; L S Gottlieb; S S Sternberg; J D Waye; M Schapiro; J H Bond; J F Panish Journal: N Engl J Med Date: 1993-12-30 Impact factor: 91.245