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Cost-Effectiveness Analysis of Implementing a Multisectoral Program for Colorectal Cancer Screening in an African
Tzeyu L Michaud1,2, Paul A Estabrooks3, Hongying Daisy Dai4
1Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska.
AJPM Focus
|October 2, 2025
Summary
On-site fecal immunochemical testing (FIT) kit distribution is a cost-effective strategy to increase colorectal cancer screening in African American communities. This community outreach program demonstrated practical implementation and improved screening rates.
Area of Science:
- Public Health
- Health Services Research
- Cancer Screening
Background:
- Colorectal cancer (CRC) screening uptake remains low among African Americans.
- Community-based interventions are crucial for addressing health disparities.
- Fecal immunochemical test (FIT) is a non-invasive screening method.
Purpose of the Study:
- To determine the costs and cost-effectiveness of a multicomponent FIT intervention for CRC screening.
- To compare on-site FIT distribution versus mailing FIT kits upon request.
- To estimate the budget impact of sustaining the program.
Main Methods:
- Cost-effectiveness and budget impact analyses were conducted.
- Data were collected from a community CRC screening outreach trial (January-April 2022).
- Evaluated average and incremental cost-effectiveness ratios and performed sensitivity analysis for replication costs.
Main Results:
- The overall program cost was $14,541 over 3 months.
- On-site distribution cost $8,629 (110 participants), mailing cost $5,912 (99 participants).
- Average cost-effectiveness ratios were $70/person enrolled, $246/participant screened, and $969/positive test.
Conclusions:
- On-site FIT kit distribution is an effective, practical, and low-cost community outreach strategy.
- This approach improves CRC screening rates in African American communities.
- Further research is needed on program sustainability and scalability in diverse settings.
