OBJECTIVES: Ireland’s colorectal cancer screening programme, BowelScreen, offers biennial faecal immunochemical testing (FIT) for 60-69 year-olds. Screening sensitivity and specificity of FIT are adjusted by varying the test positivity threshold. BowelScreen uses a FIT cut-off of 225ng/ml of haemoglobin. Existing literature indicates that a lower cut-off of 50ng/ml would cost less and be more effective, but require more colonoscopies for positive screen findings, which is a key capacity constraint. The objective of this study was to determine if a more effective, less costly screening strategy exists within BowelScreen’s current colonoscopy capacity requirements. METHODS: The MISCAN cancer screening model was used to simulate 144 strategies of varying screening intervals, age ranges and FIT cut-offs. Outputs estimated were net costs, quality-adjusted life-years (QALYs) and number of colonoscopies required. RESULTS: A combination of a reduction in the FIT cut-off to 50ng/ml, an extended screening interval of 3 years and a reduced screening start age of 55 saves 20% more QALYs, reduces costs by 7%, and yields a 17% reduction in colonoscopy requirements. CONCLUSIONS: Simple changes to BowelScreen could save lives, reduce costs and relieve pressure on colonoscopy capacity.
|Publication status||Published - 20 May 2017|
|Event||International Society for Pharmacoeconomics and Outcomes Research: ISPOR 22nd Annual International Meeting - Sheraton Boston Hotel and the John B. Hynes Veterans Memorial Convention Center, Boston, United States|
Duration: 20 May 2017 → 24 May 2017
|Conference||International Society for Pharmacoeconomics and Outcomes Research|
|Period||20/05/2017 → 24/05/2017|
McFerran, E., & O'Mahony, J. F. (2017). Can Ireland’s colorectal screening programme save more lives, save money and live within existing colonoscopy capacity limits? Findings from the MISCAN microsimulation model. Poster session presented at International Society for Pharmacoeconomics and Outcomes Research, Boston, United States.