Researchers urge increasing CRC screening rates for high-risk patients over lowering screening age – 5 insights

A study published in Gastroenterology examined the cost effectiveness of The American Cancer Society's recommendation to begin colorectal cancer screening at age 45.

Researchers compared screening strategies and resource allocations in a validated Markov model.

What you should know:

1. Screening 1,000 patients when they turned 45 instead of 50 prevented four CRC cases and two CRC-related deaths. Patients would gain 14 quality-adjusted life years at a cost of $33,900 per year gained. However, it would require an additional 758 colonoscopies.

2. If physicians diverted those 758 colonoscopies to screen 231 unscreened 55-year-olds or 342 unscreened 65- to 75-year-olds, physicians could prevent 13 to 14 CRC cases and six to seven CRC-related deaths. Those screenings gained 27 to 28 quality-adjusted life years and saved $163,700 to $445,800 per year gained.

3. Health systems can realize benefits and savings by targeting patients with abnormal fecal immunochemical tests and completing their colonoscopy.

4. Beginning CRC screening at 45 years instead of 50 years can avert 29,400 CRC cases and 11,100 CRC deaths over the next five years. However, it would require 10.7 million additional colonoscopy at a cost of $10.4 billion.

5. If physicians shifted those resources to improving 50- to 75-year-old patient screening rates, physicians could prevent three times more CRC deaths at nearly a third of the cost.

Researchers concluded, "In a Markov model analysis, we found that starting CRC screening at age 45-years is likely to be cost effective. However, greater benefit, at lower cost, could be achieved by increasing participation rates for unscreened older and higher-risk persons."

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