Cost-effectiveness of colonoscopy in an organized screening program

Area of Science:

• Public Health
• Oncology
• Health Economics

Background:

• Colorectal cancer (CRC) poses a significant health burden globally.
• Screening programs are crucial for reducing CRC incidence and mortality.
• The cost-effectiveness of a once-in-a-lifetime colonoscopy screening program in Poland was previously unknown.

Purpose of the Study:

• To assess the cost-effectiveness of the Polish Colonoscopy Screening Platform (PCSP).
• To evaluate the impact of colonoscopy screening on CRC rates in Poland.

Main Methods:

• A Markov model was utilized to compare colonoscopy screening with no screening in 100,000 subjects.
• Data from the nationwide Polish CRC screening program informed the model.
• Incremental cost-effectiveness ratio (ICER) and sensitivity analysis (Monte Carlo simulation) were performed.

Main Results:

• Colonoscopy screening via PCSP reduced CRC incidence by 18.9% and mortality by 19.8%.
• The program resulted in a gain of 2317 life-years saved (1959 after discounting).
• The ICER was below $6500 USD, significantly lower than willingness-to-pay thresholds, confirming cost-effectiveness.

Conclusions:

• Colonoscopy screening within the PCSP is a cost-effective intervention.
• The PCSP demonstrates substantial potential to benefit Polish society through increased life-years.
• Findings offer valuable insights for health policy, medical practice, and health technology assessment.