Costs and benefits of an organized fecal immunochemical test-based colorectal cancer screening program in the United States

Authors

  • Gery P. Guy Jr PhD, MPH,

    Corresponding author
    1. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
    • Corresponding author: Gery P. Guy Jr, PhD, MPH, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS F-76, Chamblee, GA 30341; Fax: (770) 488-4760; irm2@cdc.gov

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  • Lisa C. Richardson MD, MPH,

    1. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
    Current affiliation:
    1. Division of Blood Disorders, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Michael P. Pignone MD, MPH,

    1. Division of General Internal Medicine, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
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  • Marcus Plescia MD, MPH

    1. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
    Current affiliation:
    1. Mecklenburg County Health Department, Charlotte, North Carolina
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  • The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Abstract

BACKGROUND

Despite clear recommendations and evidence linking colorectal cancer screening to lower incidence and mortality, > 40% of adults are not up to date with screening. Existing domestic and international models of organized cancer screening programs have been effective in increasing screening rates. Implementing an organized, evidence-based, national screening program may be an effective approach to increasing screening rates.

METHODS

In the current study, the authors estimated the initial investment required and the cost per person screened of a nationwide fecal immunochemical test (FIT)-based colorectal cancer screening program among adults aged 50 years to 75 years.

RESULTS

The initial additional investment required was estimated at $277.9 to $318.2 million annually, with an estimated 8.7 to 9.4 million individuals screened at a cost of $32 to $39 per person screened. The program was estimated to prevent 2900 to 3100 deaths annually.

CONCLUSIONS

The results of the current study indicate that implementing a national screening program would make a substantial public health impact at a moderate cost per person screened. Results from this analysis may provide useful information for understanding the public health benefit of an organized screening delivery system and the potential resources required to implement a nationwide colorectal cancer screening program, and help guide decisions about program planning, design, and implementation. Cancer 2014;120:2308–2315. © 2014 American Cancer Society.

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