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Cost-effectiveness of computed tomographic colonography: a prospective comparison with colonoscopy
R B Arnesen1, B Ginnerup-Pedersen, P B Poulsen
1Department of Surgery, Copenhagen University Hospital Hillerød, Hillerød, Denmark. regnar.arnesen@dadlnet.dk
Acta Radiologica (Stockholm, Sweden : 1987)
|April 25, 2007
Summary
Computed tomographic colonography (CTC) followed by colonoscopy (CC) for polyp detection is cost-effective at some centers. The overall cost-effectiveness depends on institutional factors like equipment and staff organization.
Area of Science:
- Gastroenterology
- Radiology
- Health Economics
Background:
- Colorectal polyps require effective and economical detection methods.
- Computed tomographic colonography (CTC) and conventional colonoscopy (CC) are key diagnostic tools.
Purpose of the Study:
- To evaluate the cost-effectiveness of using CTC for colorectal polyp detection followed by CC for polypectomy, compared to CC alone.
Main Methods:
- A marginal cost-effectiveness analysis was conducted on 103 patients undergoing same-day CTC and CC.
- Data on time, medication, equipment, and salaries were collected prospectively and retrospectively.
- The study compared the sensitivities of CTC and CC for detecting polyps >= 5mm or >= 6mm.
Main Results:
- CTC was cost-effective at one hospital (H-I), while CC was cost-effective at another (H-II).
- Costs per finding varied, influenced by the detection sensitivities of both procedures.
- Equipment depreciation and staff time significantly impacted overall cost-effectiveness.
Conclusions:
- CTC followed by CC for colorectal polyp detection can be a cost-effective strategy.
- Successful implementation requires appropriate institutional hardware and organizational structures.
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