Cost-benefit analysis of screening colonoscopy in 40- to 50-year-old first-degree relatives of patients with colorectal cancer

• Published in: International journal of colorectal disease Vol. 21; no. 6; pp. 596 - 601
• Main Authors: MENGES, Markus, GÄRTNER, Barbara, GEORG, Thomas, FISCHINGER, Johannes, ZEITZ, Martin
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.09.2006; Berlin Springer Nature B.V
• Subjects: Adult; Biological and medical sciences; Colonoscopy - economics; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - economics; Colorectal Neoplasms - genetics; Cost-Benefit Analysis; Digestive system. Abdomen; Endoscopy; Gastroenterology. Liver. Pancreas. Abdomen; Genetic Predisposition to Disease; Germany; Humans; Investigative techniques, diagnostic techniques (general aspects); Mass Screening - economics; Mass Screening - methods; Medical sciences; Middle Aged; Pedigree; Prognosis; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Germany; Human; Rectal disease; Colorectal cancer; Screening colonoscopy; Malignant tumor; Cost benefit analysis; Medical screening; Familial risk; Colonic disease; Cost-benefit analysis; Colorectal adenoma; Colonoscopy; Risk factor; Gastroenterology; Digestive diseases; Intestinal disease; Benign neoplasm; Endoscopy
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-005-0058-5

As shown previously, 40- to 50-year-old first-degree relatives of patients with colorectal cancer (CRC) have significantly more colorectal adenomas than controls of the same age. Screening colonoscopy of these persons at risk between 40 and 50 years might be cost beneficial. We prepared a detailed cost-benefit analysis of screening colonoscopy and possible repeat endoscopies according to current expenditures for endoscopic procedures in Germany. Since screening colonoscopy is generally offered and reimbursed from 55 years on in Germany, we analysed the period between 45 and 55 years, taking an annual interest rate of 5% into account. Costs were analysed based on the results of a former study [11] depending on various participation rates in a general screening programme. Based on the available 1994 figure of about 20,000 euros for diagnosis and treatment of one cancer case, screening colonoscopy is cost beneficial when participation is high. Under a more realistic assumption of currently about 40,000 euros per cancer case, screening colonoscopy is cost beneficial in any case. Our data support that systematic screening colonoscopy in first-degree relatives of patients with CRC by the age of 45 years most likely demonstrates an economic benefit.