Tokyo, Japan - Though the incidence and mortality of colorectal cancer can be reduced by regularly screening uptake, the current screening program, fecal occult blood test (FOBT) followed by optical colonoscopy (OC), does not work well due to low uptake rate of OC. Computed Tomography Colonography (CTC) implementation after FOBT can be a solution but its cost-effectiveness may be seen as an issue for policy makers.
Researchers from the National Cancer Center and the University of Tokyo in Tokyo, Japan, assessed the cost-effectiveness of CTC implementation for a colorectal cancer screening program in the working-age population from the health care payer’s perspective in Japan.
Two strategies were used to study the cost-effectiveness of CTC implementations: 1) All FOBT-positive cases would be offered CTC followed by OC; and 2) only FOBT-positive cases that were reluctant to undergo OC would be offered CTC followed by OC. The incremental cost-effectiveness ratio (ICER) of the first strategy compared to the current strategy was JPY 1,646,000 per QALY gained and the second strategy was dominant against the current strategy.
Under the assumptions of 2012 Japan, CTC implementations for a colorectal cancer screening program for the working-age population (aged 40 to 60) in Japan were cost-effective since the ICER was well below the Japanese threshold (JPY5mil/QALY gained).
“These results truly show that introducing computed tomography colonography into the current colorectal cancer screening program would be cost effective , which could be helpful information for governmental/regional decision makers of public funding/promotion programs,” says the lead researcher on the study, Yoshihiko Hashimoto, BS, student at Graduate School of Pharmaceutical Sciences at University of Tokyo in Japan.
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