Clinical-alimentary tractFecal DNA testing compared with conventional colorectal cancer screening methods: a decision analysis
Section snippets
Literature review
We searched MEDLINE from 1980 to 2003 for English language literature using the terms colorectal neoplasm, colorectal polyp, screening, occult blood, sigmoidoscopy, colonoscopy, fecal DNA testing, cost, and cost-effectiveness. In addition, we reviewed abstracts from national meetings, data from Medicare, and relevant unpublished data from EXACT Sciences Corporation (Marlboro, MA), a company marketing a fecal DNA test. Model inputs for the conventional screening strategies relied on previously
Selection of screening interval for F-DNA
F-DNA at progressively shorter screening intervals yielded increasing average life expectancies at progressively higher costs (Figure 2). The cost per incremental life-year gained increased in an accelerating fashion for progressively shorter intervals (Figure 2). For a cohort of 100,000 persons, F-DNA every 8 years compared with no screening gained an incremental 3440 life-years at a cost of $42,200/life-year gained. F-DNA every 5 years compared with every 6 years gained an incremental 410
Discussion
Our computer simulation of screening for CRC and polyps with conventional methods or novel fecal DNA testing suggests that all of these strategies are effective and cost-effective compared with no screening. However, in determining the potential role of fecal DNA testing in a national strategy to decrease the burden of CRC, we must ask how it compares with screening colonoscopy and with other tests designed to select patients for colonoscopy. Our results suggest that fecal DNA testing with
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Cost-effectiveness of High-performance Biomarker Tests vs Fecal Immunochemical Test for Noninvasive Colorectal Cancer Screening
2018, Clinical Gastroenterology and HepatologyCitation Excerpt :However, uptake increases of more than 20% are unlikely, because FIT can also be offered with patient navigation. Several studies have evaluated the cost-effectiveness of specific biomarker tests.35–42 The majority of the studies considered various versions of the fecal DNA test, and unit costs, including laboratory analysis, varied between $51 (Taiwanese population) and $825 (U.S. population).
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A. Mark Fendrick is on the Speaker’s Bureau of Exact Sciences.