Cost-effectiveness of screening for common cancers

Area of Science:

• Health Economics
• Preventive Medicine
• Public Health Policy

Background:

• Cost-effectiveness analysis (CEA) has influenced healthcare decisions for nearly two decades.
• Legislative coverage for cancer screening tests often relies on CEA studies.
• CEA views healthcare investments through a societal lens, measuring returns in health improvements.

Purpose of the Study:

• To review the principles of cost-effectiveness analysis in healthcare.
• To illustrate the strengths and weaknesses of CEA using cervical and colorectal cancer screening.
• To highlight the impact of CEA on decision-making for preventive services.

Main Methods:

• Review of principles of cost-effectiveness analysis.
• Examination of existing CEA studies for cervical and colorectal cancer screening.
• Discussion of inherent limitations, including reliance on disease models and uncertainty in costs/benefits.

Main Results:

• CEA evaluations indicate that both cervical and colorectal cancer screening are cost-effective compared to no screening.
• Existing studies have not definitively established the optimal screening strategy for either cancer.
• New evidence necessitates updated disease models for cervical cancer screening CEA.
• Colorectal cancer screening models require validation against recent clinical trial data.

Conclusions:

• Despite inherent uncertainties and contradictions, CEA models compel consideration of all healthcare cost and outcome consequences.
• Further research and model refinement are crucial for optimizing cancer screening strategies.
• CEA remains a vital tool for informing policy and clinical decisions regarding preventive services.