A loss-effectiveness analysis of risk-adapted surveillance after colorectal polypectomy

Surveillance of patients after initial polypectomy is considered as an effective means to prevent the development of colorectal carcinoma. Several proposals with varying follow-up schedules are given in the literature. Based on a growing awareness on possibilities to prevent colorectal cancer from developing, the discovery of colorectal adenoma and consequently the need for surveillance by colonoscopy will increase. In this paper, a strategy for a cost-effectiveness analysis of adenoma surveillance will be discussed. Obstacles to reach a conclusive result are pointed out, gaps in information needed are marked, modelling techniques used in a sound sensitivity analysis will be described.