Projected dynamics of colonoscopic screening and surveillance for colorectal cancer

We used a simulation model of statistical analysis to estimate the cost and procedural burden of colorectal cancer (CRC) screening and surveillance using colonoscopy.

The estimated financial resources have been evaluated by multiplying half of the scheduled colonoscopies with the cost of one surveillance colonoscopy, dividing the result to the median time in which the procedures are performed, according to the Kaplan-Meier curve of scheduled procedures.

Three hundred and thirty-eight patients (72.5%) were included in the registry for colonoscopic surveillance after a curative resection for colorectal cancer, 101 patients (21.7%) for follow-up after endoscopic polypectomies of adenomatous polyps, 21 patients (4.5%) for long lasting inflammatory bowel disease (IBD), and 2 patients (0.4%) for familial adenomatous polyposis. The projected dynamics and costs of colonoscopies scheduled for one year in our center indicate 11650 Euro/9.4 months spending for all procedures, 8450 Euro/8.8 months for surveillance after curative resection for CRC, 2525 Euro/24.9 months for surveillance after endoscopic polypectomies of adenomatous polyps and 525 Euro/6.8 months for screening for CRC in patients with long history of IBD, respectively.

Screening and surveillance for CRC in a Romanian gastroenterology center represents an important activity in both workload and costs.