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Related Experiment Videos

What do we gain from the sixth stool guaiac?

D Neuhauser, A M Lewicki

    The New England Journal of Medicine
    |July 31, 1975
    PubMed
    Summary

    The six-step stool guaiac test for colon cancer screening becomes exponentially more expensive per case detected. Lowering test sensitivity and increasing cancer prevalence can reduce the marginal cost of screening.

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    Area of Science:

    • Gastroenterology
    • Oncology
    • Health Economics

    Background:

    • Colorectal cancer screening is crucial for early detection.
    • The six-step sequential stool guaiac protocol is a common screening method.

    Purpose of the Study:

    • To analyze the cost-effectiveness of the sequential stool guaiac protocol for colon cancer screening.
    • To determine the factors influencing the marginal cost per detected case.

    Main Methods:

    • Economic analysis of the six-step stool guaiac protocol.
    • Calculation of marginal cost per cancer case detected at each sequential step.

    Main Results:

    • The cost of detecting colon cancer rises exponentially with each sequential stool guaiac test.
    • The marginal cost of the sixth test can be 20,000 times the average cost.
    • Marginal cost decreases with lower test sensitivity and increases with lower cancer prevalence.

    Conclusions:

    • Even inexpensive screening tests can become very costly when measured by cases detected.
    • The marginal cost per case detected is significantly influenced by population prevalence and test sensitivity.

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