Comprehensive Cost Implications of Commercially Available Noninvasive Colorectal Cancer Screening Modalities.

Area of Science:

• Oncology
• Health Economics
• Preventive Medicine

Background:

• Colorectal cancer (CRC) screening utilizes noninvasive methods like fecal immunochemical test (FIT) and multi-target stool DNA test (Cologuard [CG]).
• Evaluating the long-term economic impact of these screening modalities is crucial for healthcare systems.

Purpose of the Study:

• To determine the comprehensive, long-term cost implications of FIT versus Cologuard for colorectal cancer screening.
• To assess the value of adopting FIT as the primary noninvasive CRC screening method.

Main Methods:

• Analysis of a national insurer-based administrative dataset for patients screened for CRC in 2019.
• Extrapolation of total annual costs based on patient numbers, test costs, screening intervals, and false result costs.
• Comparison of cancer stage distribution for patients diagnosed with CRC after screening, matched with claims data.

Main Results:

• FIT and Cologuard (CG) were used by 38.1% and 40.0% of 119,334 screened members, respectively.
• The combined annual cost was $13.7 million; transitioning to FIT alone could save approximately $5.8 million annually ($7.9 million total cost).
• Early-stage CRC detection rates were similar between FIT (59.5%) and CG (63.2%) screening.

Conclusions:

• Adopting FIT as the primary noninvasive CRC screening method offers substantial cost savings.
• FIT presents significant value for large population health systems due to its cost-effectiveness and comparable early-stage detection rates.