Modelling future capacity needs and spending on colonoscopy in the English bowel cancer screening programme

Area of Science:

• Gastroenterology
• Public Health
• Health Economics

Background:

• England's national bowel cancer screening program utilizes fecal occult blood testing and colonoscopy.
• Surveillance colonoscopies are recommended for individuals with intermediate- or high-risk polyps due to elevated bowel cancer risk.

Purpose of the Study:

• To project the year-on-year increase in colonoscopy volumes and associated costs.
• To inform service planning and resource allocation for bowel cancer screening and surveillance programs.

Main Methods:

• A predictive model was developed using data from the English Bowel Screening Pilot.
• The model forecasts colonoscopy volumes and costs for a hypothetical population based on current guidelines.

Main Results:

• For a population of 500,000, the initial screening and surveillance round is projected to detect 34 cancers.
• Colonoscopy numbers are expected to increase by 23 procedures annually over 8 years, primarily for surveillance.
• Annual colonoscopy costs are projected to rise by £11,808, with a cost per eligible person of £2.86 initially.

Conclusions:

• Model projections can guide service planning and resource allocation for bowel cancer screening implementation.
• Results are applicable to primary care trusts within strategic health authorities.