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Updated: Aug 10, 2026
15:17
Colorectal Cancer Cell Surface Protein Profiling Using an Antibody Microarray and Fluorescence Multiplexing
Published on: September 25, 2011
Strategies for screening for colorectal carcinoma
W L England1, J J Halls, V B Hunt
1Department of Industrial Engineering, University of Wisconsin-Madison.
Summary
For average-risk individuals, screening for colorectal cancer using a fecal occult blood test followed by a double-contrast barium enema and possibly colonoscopy is most cost-effective. Higher-risk groups may benefit from direct colonoscopy after a positive fecal occult blood test.
Area of Science:
- Gastroenterology
- Public Health
- Health Economics
Background:
- Colorectal cancer (CRC) screening is crucial for early detection and improved patient outcomes.
- Various screening tests and strategies exist, each with different cost-effectiveness profiles.
- Identifying the most economically viable screening approach is essential for resource allocation.
Purpose of the Study:
- To evaluate the cost-effectiveness of different screening strategies for colorectal cancer.
- To compare thirteen combinations of commonly used CRC detection tests.
- To determine optimal screening pathways for average-risk and higher-risk populations.
Main Methods:
- Cost-effectiveness analysis of four CRC screening tests and thirteen combinations.
- Modeling of diagnostic costs and years of extended life.
- Sensitivity analysis to assess the robustness of findings regarding test costs, sensitivity, and specificity.
Main Results:
- The most cost-effective strategy for average-risk individuals involves a fecal occult blood test (FOBT) followed by a double-contrast barium enema (DCBE) and, if needed, colonoscopy.
- For higher-risk individuals or populations with high adenomatous polyp frequency, a positive FOBT followed directly by colonoscopy is a cost-effective alternative.
- The frequency of adenomatous polyps significantly impacts diagnostic costs, while cancer frequency influences the cost per year of extended life.
Conclusions:
- The recommended FOBT-DCBE-colonoscopy strategy offers superior cost-effectiveness for average-risk CRC screening.
- Direct colonoscopy after FOBT is a viable and cost-effective alternative for specific higher-risk groups.
- These findings provide valuable insights for optimizing CRC screening program resource allocation and effectiveness.
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