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Showing content from https://pubmed.ncbi.nlm.nih.gov/35106276/ below:

Life-years gained resulting from screening colonoscopy compared with follow-up colonoscopy after a positive stool-based colorectal screening test

doi: 10.1016/j.pmedr.2022.101701. eCollection 2022 Apr. Life-years gained resulting from screening colonoscopy compared with follow-up colonoscopy after a positive stool-based colorectal screening test

Affiliations

¹ Division of General Medicine, University of Michigan, Ann Arbor, MI, USA.
² Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA.
³ Exact Sciences Corp, Madison, WI, USA.
⁴ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

PMID: 35106276
PMCID: PMC8789575
DOI: 10.1016/j.pmedr.2022.101701

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Life-years gained resulting from screening colonoscopy compared with follow-up colonoscopy after a positive stool-based colorectal screening test

A Mark Fendrick et al. Prev Med Rep. 2022.

doi: 10.1016/j.pmedr.2022.101701. eCollection 2022 Apr. Affiliations

¹ Division of General Medicine, University of Michigan, Ann Arbor, MI, USA.
² Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA.
³ Exact Sciences Corp, Madison, WI, USA.
⁴ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

PMID: 35106276
PMCID: PMC8789575
DOI: 10.1016/j.pmedr.2022.101701

Item in Clipboard

Abstract

Screening colonoscopies for colorectal cancer (CRC) are typically covered without patient cost-sharing, whereas follow-up colonoscopies for positive stool-based screening tests often incur patient costs. The objective of this analysis was to estimate and compare the life-years gained (LYG) per average-risk screening colonoscopy and follow-up colonoscopy after a positive stool-based test to better inform CRC coverage policy and reimbursement decisions. CRC outcomes from screening and follow-up colonoscopies versus no screening were estimated using CRC-AIM in a simulated population of average-risk individuals screened between ages 45-75 years. The LYG/colonoscopy per 1000 individuals was 0.09 for screening colonoscopy and 0.29 for follow-up colonoscopy. 0.01 and 0.04 CRC cases and 0.01 and 0.02 CRC deaths were averted per screening and follow-up colonoscopies, respectively. Coverage policies should be revised to encourage individuals to complete recommended screening processes.

Keywords: Adenoma; CRC, colorectal cancer; CRC-AIM, Colorectal Cancer and Adenoma Incidence and Mortality Microsimulation Model; Colonoscopy; Colorectal cancer; FIT, fecal immunochemical test; LYG, life-years gained; Life-years gained; Screening; Simulation model; Stool-based test; mt-sDNA, multitarget stool DNA.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: A.M. Fendrick has been a consultant for AbbVie, Amgen, Centivo, Community Oncology Association, Covered California, EmblemHealth, Exact Sciences, Freedman Health, GRAIL, Harvard University, Health & Wellness Innovations, Health at Scale Technologies, MedZed, Penguin Pay, Risalto, Sempre Health, the State of Minnesota, U.S. Department of Defense, Virginia Center for Health Innovation, Wellth, and Zansors; has received research support from the Agency for Healthcare Research and Quality, Gary and Mary West Health Policy Center, Arnold Ventures, National Pharmaceutical Council, Patient-Centered Outcomes Research Institute, Pharmaceutical Research and Manufacturers of America, the Robert Wood Johnson Foundation, the State of Michigan, and the Centers for Medicare and Medicaid Services. B.J. Borah has nothing to disclose. L. Saoud and A.B. Ozbay are employees of Exact Sciences Corporation. P.J. Limburg serves as Chief Medical Officer for Screening at Exact Sciences through a contracted services agreement with Mayo Clinic. Dr. Limburg and Mayo Clinic have contractual rights to receive royalties through this agreement.

Figures
Fig. 1

Predicted life-years-gained (LYG) per screening…

Fig. 1

Predicted life-years-gained (LYG) per screening colonoscopy or follow-up colonoscopy for positive stool-based tests…

Fig. 1

Predicted life-years-gained (LYG) per screening colonoscopy or follow-up colonoscopy for positive stool-based tests in individuals screened from ages 45–75. Data are per 1000 individuals.