Activities per year
Abstract
Introduction: Colorectal cancer (CRC) prevention programmes using faecal immunochemical testing (FIT) as the primary screen typically rely on colonoscopy for secondary and surveillance testing. Colonoscopy capacity is an important constraint, limiting the number of primary tests offered. Many European programmes lack sufficient colonoscopy capacity to provide optimal screening intensity regarding screening age ranges, intervals and FIT cut-offs. It is currently unclear how to optimise programmes within colonoscopy capacity constraints. Design: The MISCAN-Colon microsimulation model was used to determine if more effective CRC screening programmes can be identified within existing colonoscopy capacity. The model assessed 525 strategies of varying screening intervals, age ranges and FIT cut-offs, including previously unevaluated 4 and 5 year screening intervals. These strategies were compared with policy decisions taken in Ireland to provide CRC screening within available colonoscopy capacity. Outcomes estimated net costs, quality-adjusted-life-years and required colonoscopy numbers. The optimal strategies within finite colonoscopy capacity constraints were identified. Results: Combining a reduced FIT cut-off of 10 micrograms Hb/g, an extended screening interval of 4 years and an age range of 60-72 years requires 6% fewer colonoscopies, reduces net costs by 23% while preventing 15% more CRC deaths and saving 16% more QALYs relative to current policy. Conclusion: Previously overlooked longer screening intervals may balance optimal cancer prevention with finite colonoscopy capacity constraints. Simple changes to screening configurations could save lives, reduce costs, and relieve colonoscopy capacity pressures. These findings are directly relevant to CRC screening programmes across Europe that employ FIT-based testing and face colonoscopy capacity constraints.
Original language | English |
---|---|
Type | Online preprint |
Media of output | MedRxiv preprint server |
DOIs | |
Publication status | Published - 19 Dec 2020 |
Publication series
Name | medRxiv |
---|
Keywords
- medRxiv
- Preprint
- Capacity planning
- Colonoscopy
- faecal immunochemical testing
- Cancer
- Screening
Fingerprint
Dive into the research topics of 'Colorectal cancer screening within colonoscopy capacity constraints: can FIT-based programmes save more lives by trading-off more sensitive test cut-offs against longer screening intervals?'. Together they form a unique fingerprint.Activities
-
Consultation Workshop, Irish Cancer Society and the National Screening Service
McFerran, E. (Invited speaker) & O'Mahony, J. F. (Invited speaker)
07 Oct 2019Activity: Talk or presentation types › Invited talk
-
Erasmus University Medical Center
McFerran, E. (Contributor) & O'Mahony, J. F. (Contributor)
06 Jun 2019Activity: Visiting an external institution types › Visiting an external academic institution
-
How Ireland’s Colorectal Screening Programme Could SAVE MORE LIVES, SAVE MONEY & Stay Within Existing Colonoscopy Capacity Limits: Evidence From The MISCAN Microsimulation Model
McFerran, E. (Advisor), O'Mahony, J. F. (Contributor), McVicar, D. (Advisor), Zauber, A. (Advisor), Kee, F. (Advisor) & Lansdorp_Vogelaar, I. (Advisor)
16 Nov 2018Activity: Talk or presentation types › Invited talk
Prizes
-
HSC R&D/National Cancer Institute Health Economics Fellowship
McFerran, E. (Recipient), 2014
Prize: Fellowship awarded competitively
Research output
- 1 Article
-
Colorectal Cancer Screening within Colonoscopy Capacity Constraints: Can FIT-Based Programs Save More Lives by Trading off More Sensitive Test Cutoffs against Longer Screening Intervals?
McFerran, E., O'Mahony, J. F., Naber, S., Sharp, L., Zauber, A. G., Lansdorp-Vogelaar, I. & Kee, F., 01 Jan 2022, In: MDM Policy & Practice.Research output: Contribution to journal › Article › peer-review
Open AccessFile52 Downloads (Pure)