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Showing content from http://www.ncbi.nlm.nih.gov/pubmed/28190597 below:

Costs of colorectal cancer screening provision in CDC's Colorectal Cancer Control Program: Comparisons of colonoscopy and FOBT/FIT based screening

doi: 10.1016/j.evalprogplan.2017.02.007. Epub 2017 Feb 7. Costs of colorectal cancer screening provision in CDC's Colorectal Cancer Control Program: Comparisons of colonoscopy and FOBT/FIT based screening

Affiliations

¹ RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452, USA. Electronic address: ssubramanian@rti.org.
² Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA.
³ RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452, USA.

PMID: 28190597
PMCID: PMC5863533
DOI: 10.1016/j.evalprogplan.2017.02.007

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Costs of colorectal cancer screening provision in CDC's Colorectal Cancer Control Program: Comparisons of colonoscopy and FOBT/FIT based screening

Sujha Subramanian et al. Eval Program Plann. 2017 Jun.

doi: 10.1016/j.evalprogplan.2017.02.007. Epub 2017 Feb 7. Affiliations

¹ RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452, USA. Electronic address: ssubramanian@rti.org.
² Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA.
³ RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452, USA.

PMID: 28190597
PMCID: PMC5863533
DOI: 10.1016/j.evalprogplan.2017.02.007

Item in Clipboard

Abstract

We assess annual costs of screening provision activities implemented by 23 of the Centers for Disease Control and Prevention's Colorectal Cancer Control Program (CRCCP) grantees and report differences in costs between colonoscopy and FOBT/FIT-based screening programs. We analysed annual cost data for the first three years of the CRCCP (July 2009-June 2011) for each screening provision activity and categorized them into clinical and non-clinical screening provision activities. The largest cost components for both colonoscopy and FOBT/FIT-based programs were screening and diagnostic services, program management, and data collection and tracking. During the first 3 years of the CRCCP, the average annual clinical cost for screening and diagnostic services per person served was $1150 for colonoscopy programs, compared to $304 for FIT/FOBT-based programs. Overall, FOBT/FIT-based programs appear to have slightly higher non-clinical costs per person served (average $1018; median $838) than colonoscopy programs (average $980; median $686). Colonoscopy-based CRCCP programs have higher clinical costs than FOBT/FIT-based programs during the 3-year study timeframe (translating into fewer people screened). Non-clinical costs for both approaches are similar and substantial. Future studies of the cost-effectiveness of colorectal cancer screening initiatives should consider both clinical and non-clinical costs.

Keywords: Activity-based costing; Colorectal cancer screening; Economic evaluation; Screening cost.

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Figures
Fig. A1

CRCCP Screening Provision Program Components…

Fig. A1

CRCCP Screening Provision Program Components and Specific Activities*. CRCCP Colorectal Cancer Control Program…

Fig. A1

CRCCP Screening Provision Program Components and Specific Activities*. CRCCP Colorectal Cancer Control Program * Screening promotion activities are reported in a companion manuscript (20) ** Overarching component supports screening provision and screening promotion activities; the costs of the overarching component assigned to screening provision are reported in this study. *** For example, support activities such as information management.

Fig. 1

Percent Distribution of Costs for…

Fig. 1

Percent Distribution of Costs for Program Activities by Screening Tests. FOBT fecal occult…

Fig. 1

Percent Distribution of Costs for Program Activities by Screening Tests. FOBT fecal occult blood test; FIT fecal immunochemical test Note: Other activities include costs that could not be separated into specific activities

Fig. 2

Median Cost by Activity for…

Fig. 2

Median Cost by Activity for Each of the Three Years of the CRCCP.…

Fig. 2

Median Cost by Activity for Each of the Three Years of the CRCCP. Note: Patient navigation cost only collected in year 2 and year 3. Other activities include costs that could not be separated into specific activities. The number of individuals screened in the FOBT/FIT based programs in first year was 2,365 and this increased to 6,197 in the third year. Correspondingly, for colonoscopy programs the screening numbers were 2,723 and 4,700. CRCCP Colorectal Cancer Control Program; FOBT fecal occult blood test; FIT fecal immunochemical test

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References

1. Centers for Disease Control and Prevention. Vital signs: Colorectal cancer screening test use—United States, 2012. MMWR. Morbidity and Mortality Weekly Report. 2013;62:881–888. - PMC - PubMed
1. Drummond M, Schulpher M, Torrance G, O’Brien B, Stoddard G. Methods for the economic evaluation of health care programmes. Oxford, England: Oxford University Press; 2005.
1. Ekwueme DU, Subramanian S, Trogdon JG, Miller JW, Royalty JE, Li C, et al. Cost of services provided by the national breast and cervical cancer early detection program. Cancer. 2014;120(Suppl 16):2604–2611. - PMC - PubMed
1. Fisher JA, Fikry C, Troxel AB. Cutting cost and increasing access to colorectal cancer screening: Another approach to following the guidelines. Cancer Epidemiology, Biomarkers and Prevention. 2006;15:108–113. - PubMed
1. National Colorectal Cancer Roundtable. Tools & resources—80% [screening rate] by 2018. National Colorectal Cancer Roundtable; n.d. Accessed from http://nccrt.org/tools/80-percent-by-2018.

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