Is colonoscopy or CT colonography more cost effective for colorectal cancer screening?

Traditional colonoscopy is considered standard in screening for colorectal cancer (CRC), but CT colonography offers an alternative that can be more patient friendly.

A team of Dutch scientists set out to determine which method is more cost effective according to a new study published online Feb. 27 in Radiology.

Researchers used data from the Colonoscopy or Colonography for Screening (COCOS) to create a microsimulation model in comparing CT colonography and colonoscopy. Participation rates for CT colonography were higher (33.6 percent) than those for colonoscopy (21.5 percent).

Overall, the group determined CT colonoscopy more cost effective in screening strategies involving more than two lifetime exams. In plans involving one or two lifetime exams, colonoscopy was the preferred method.

“The results of this study confirm that, for people willing to participate in CRC screening, colonoscopy is more cost effective than CT colonography screening,” wrote corresponding author Miriam P. van der Meulen, MD, with the department of public health at Academic Medical Center in Amsterdam, and colleagues. “However, from a population’s perspective, with participation as observed in the COCOS trial, colonoscopy screening is less cost-effective than CT colonography screening if the latter offers more than two lifetime screenings.”

While authors noted this analysis was performed in the Dutch setting, they believe its results are applicable to other regions as well.

“Although absolute participation rates and costs may differ among countries, the relative differences between CT colonography and colonoscopy primarily determine the comparative effectiveness,” wrote Meulen et al.