Daniele Regge, MD, from the radiology unit at the Institute for Cancer Research and Treatment in Candiolo, Italy, and colleagues set out to analyze the cost-effectiveness of adding CAD to a CTC screening program and to compare it with other options of colorectal cancer prevention.
The researchers compared the cost-effectiveness of screening strategies by using CTC with and without CAD, flexible sigmoidoscopy and optical colonoscopy by using a Markov-based computer model. In the model, a hypothetical population of 100,000 persons aged 50 years underwent colorectal screening every 10 years.
At baseline, Regge and colleagues found that the addition of CAD resulted in 9 percent and 2 percent increases in colorectal cancer prevention rates for inexperienced and experienced readers, respectively, when compared with CTC without CAD.
Assuming CAD cost of $50 per CTC, the overall program costs increased by only 3 to 5 percent, largely due to the substantial reduction in colorectal cancer -related costs, according to the authors. The incremental cost-effectiveness of CTC with CAD compared with CT colonography without CAD was $8,661 and $61,354 per life-year gained for inexperienced and experienced readers, respectively.
Investigators found that optical colonoscopy was not a cost-effective alternative to CTC with CAD performed by experienced readers, with an incremental cost-effectiveness of $498,668 per life-year gained. CTC with CAD for inexperienced readers was more clinically effective and cost-effective than flexible sigmoidoscopy.
The authors concluded that the sensitivity of CTC with CAD for polyps 6 mm or larger was the most meaningful variable.