J Worthington1, E Feletto2, J B Lew2, K Broun3, S Durkin3, M Wakefield3, P Grogan2, T Harper3, K Canfell4. 1. Cancer Research Division, Cancer Council NSW, New South Wales, Australia. Electronic address: Joachim.Worthington@nswcc.org.au. 2. Cancer Research Division, Cancer Council NSW, New South Wales, Australia. 3. Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia. 4. Cancer Research Division, Cancer Council NSW, New South Wales, Australia; Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
Abstract
OBJECTIVES: The Australian National Bowel Cancer Screening Program (NBCSP) offers free 2-yearly immunochemical faecal occult blood testing to individuals aged 50-74 years; national participation in 2015-2016 was 41%. In 2017, a 7-week television-led mass-media campaign to increase participation in the Australian state of Victoria was associated with a 1.31-fold increase in participation for 11 weeks. We aimed to evaluate the cost-effectiveness and health benefits of the 2017 campaign and scaled-up equivalent campaigns run over 4 years in Victoria and nationally. STUDY DESIGN: This study used microsimulation modelling. METHODS: A comprehensive microsimulation model of colorectal cancer (CRC), Policy1-Bowel, was used to simulate three scenarios. Scenario 1 simulated the 2017 campaign in Victoria; Scenarios 2 and 3 assumed that campaigns were run three times annually from 2019 to 2022 in Victoria and Australia-wide, respectively. Total campaign costs of AUD$1million, AUD$10million, and AUD$40million were assumed for Scenarios 1, 2, and 3, respectively. The incremental effects and costs of the campaign on the NBCSP were assessed. A governmental perspective was used. RESULTS: All campaign scenarios were predicted to be highly cost-effective, with cost-effectiveness ratios under AUD$4,800/life-year saved. The actual 2017 campaign in Victoria is estimated to prevent 319 CRC cases and 183 deaths over the following 40 years. A 4-year campaign would prevent 1,750 CRC cases and 987 deaths if conducted in Victoria, and 8,100 cases and 4,330 deaths if conducted Australia-wide. CONCLUSION: Mass-media participation campaigns could be highly cost-effective and maximise the potential life-saving impact of bowel screening. These results support ongoing investment in major bowel screening campaigns.
OBJECTIVES: The Australian National Bowel Cancer Screening Program (NBCSP) offers free 2-yearly immunochemical faecal occult blood testing to individuals aged 50-74 years; national participation in 2015-2016 was 41%. In 2017, a 7-week television-led mass-media campaign to increase participation in the Australian state of Victoria was associated with a 1.31-fold increase in participation for 11 weeks. We aimed to evaluate the cost-effectiveness and health benefits of the 2017 campaign and scaled-up equivalent campaigns run over 4 years in Victoria and nationally. STUDY DESIGN: This study used microsimulation modelling. METHODS: A comprehensive microsimulation model of colorectal cancer (CRC), Policy1-Bowel, was used to simulate three scenarios. Scenario 1 simulated the 2017 campaign in Victoria; Scenarios 2 and 3 assumed that campaigns were run three times annually from 2019 to 2022 in Victoria and Australia-wide, respectively. Total campaign costs of AUD$1million, AUD$10million, and AUD$40million were assumed for Scenarios 1, 2, and 3, respectively. The incremental effects and costs of the campaign on the NBCSP were assessed. A governmental perspective was used. RESULTS: All campaign scenarios were predicted to be highly cost-effective, with cost-effectiveness ratios under AUD$4,800/life-year saved. The actual 2017 campaign in Victoria is estimated to prevent 319 CRC cases and 183 deaths over the following 40 years. A 4-year campaign would prevent 1,750 CRC cases and 987 deaths if conducted in Victoria, and 8,100 cases and 4,330 deaths if conducted Australia-wide. CONCLUSION: Mass-media participation campaigns could be highly cost-effective and maximise the potential life-saving impact of bowel screening. These results support ongoing investment in major bowel screening campaigns.
Authors: Eleonora Feletto; Jie-Bin Lew; Joachim Worthington; Emily He; Michael Caruana; Katherine Butler; Harriet Hui; Natalie Taylor; Emily Banks; Karen Barclay; Kate Broun; Alison Butt; Rob Carter; Jeff Cuff; Anita Dessaix; Hooi Ee; Jon Emery; Ian M Frayling; Paul Grogan; Carol Holden; Christopher Horn; Mark A Jenkins; James G Kench; Maarit A Laaksonen; Barbara Leggett; Gillian Mitchell; Susan Morris; Bonny Parkinson; D James St John; Linda Taoube; Katherine Tucker; Melanie A Wakefield; Robyn L Ward; Aung Ko Win; Daniel L Worthley; Bruce K Armstrong; Finlay A Macrae; Karen Canfell Journal: BMJ Open Date: 2020-06-21 Impact factor: 2.692
Authors: Joachim Worthington; Jie-Bin Lew; Eleonora Feletto; Carol A Holden; Daniel L Worthley; Caroline Miller; Karen Canfell Journal: PLoS One Date: 2020-02-03 Impact factor: 3.240
Authors: David E Goldsbury; Eleonora Feletto; Marianne F Weber; Philip Haywood; Alison Pearce; Jie-Bin Lew; Joachim Worthington; Emily He; Julia Steinberg; Dianne L O'Connell; Karen Canfell Journal: PLoS One Date: 2021-11-29 Impact factor: 3.240