Stool DNA testing not cost-effective for colon cancer screening

January 01, 0001

Stool DNA testing not cost-effective for colon cancer screening

The objective of this study by Dutch and US authors was to evaluate the conditions under which stool DNA testing could be cost-effective compared with the colorectal cancer screening tests currently reimbursed by the Centers for Medicare & Medicaid Services. They designed a comparative microsimulation modeling study using 2 independently developed models using data sources derived from literature. The target population was a cohort of persons aged 65 years. A sensitivity analysis was also conducted, in which a cohort of persons aged 50 years was studied. The intervention studied was stool DNA test every 3 or 5 years in comparison with currently recommended colorectal cancer screening strategies.

They found: "Results of Base-Case Analysis: Assuming a cost of $350 per test, strategies of stool DNA testing every 3 or 5 years yielded fewer life-years and higher costs than the currently recommended colorectal cancer screening strategies. Screening with the stool DNA test would be cost- effective at a per-test cost of $40 to $60 for stool DNA testing every 3 years, depending on the simulation model used. There were no levels of sensitivity and specificity for which stool DNA testing would be cost- effective at its current cost of $350 per test. Stool DNA testing every 3 years would be cost-effective at a cost of $350 per test if the relative adherence to stool DNA testing were at least 50% better than that with other screening tests. Results of Sensitivity Analysis: None of the results changed substantially when a cohort of persons aged 50 years was considered."

The authors concluded: "Stool DNA testing could be a cost- effective alternative for colorectal cancer screening if the cost of the test substantially decreased or if its availability would entice a large fraction of otherwise unscreened persons to receive screening."

Perhaps the manufacturer will consider an appropriate reduction in what they charge for this test.

For the full abstract, click here.

Annals of Internal Medicine 153(6):368-377, 21 September 2010 © 2010 to the American College of Physicians
Stool DNA Testing to Screen for Colorectal Cancer in the Medicare Population-A Cost-Effectiveness Analysis. Iris Lansdorp-Vogelaar, Karen M. Kuntz, Amy B. Knudsen, Janneke A. Wilschut, Ann G. Zauber, and Marjolein van Ballegooijen. Correspondence to Dr. Vogelaar: [email protected]

Category: D. Digestive. Keywords: colon cancer screening, stool DNA testing, cost-effectiveness analysis, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 5 October 2010

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