Economic evaluations of screening strategies for the early detection of colorectal cancer in the average-risk population: A systematic literature review

English version

Autoři: Joan Mendivil ^aff001; Marilena Appierto ^aff002; Susana Aceituno ^aff002; Mercè Comas ^aff003; Montserrat Rué ^aff004
Působiště autorů: Outcomes Research and Epidemiology, Shire International GmbH, a Takeda Company, Zug, Switzerland ^aff001; Health Economics department, Outcomes’ 10 SLU, Castellon, CS, Spain ^aff002; Epidemiology and Evaluation Department, IMIM (Hospital del Mar Medical Research Institute); Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Barcelona, Spain ^aff003; Departament of Basic Medical Sciences, Universitat de Lleida, Lleida, Spain ^aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0227251

Souhrn

Background

Colorectal cancer (CRC) screening has proven effective in reducing CRC mortality. This study aimed to systematically review, and evaluate the reporting quality, of the economic evidence regarding CRC screening in average-risk individuals.

Methods

Databases searched included Medline, EMBASE, National Health Service Economic Evaluation, Database of Abstracts of Reviews of Effects, Cost-Effectiveness Analysis registry, EconLit, and Health Technology Assessment database. Eligible studies were cost-effectiveness and cost-utility analyses comparing CRC screening strategies in average-risk individuals, published in English or Spanish, between January 2012 and November 2018. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.

Results

Of 1,993 publications initially retrieved, 477 were excluded by duplicate review, 1,449 by title/abstract review, and 34 by full-text review. Finally, 33 publications were included in the qualitative synthesis. Most studies were conducted in Europe (36,4%), followed by United States (24,2%) and Asia (24,2%). The main screening modalities considered were fecal immunochemical tests (70%), colonoscopy (67%), guaiac fecal occult blood test (42%) and flexible sigmoidoscopy (30%). In most studies, CRC screening was deemed cost-effective compared to no screening. Sensitivity analyses indicated that cost of CRC screening tests, adherence to screening, screening test sensitivity, and cost of CRC treatment had the greatest impact on cost-effectiveness results across studies. The majority of studies (73%) adequately reported at least 50% of the items included in the CHEERS checklist. Least well reported items included setting, study perspective, discount rate, model choice, and methods to identify effectiveness data or to estimate resource use and costs.

Conclusions

CRC screening is an efficient alternative to no screening. Nevertheless, it is not possible to conclude which strategy should be preferred for population-based screening programs. Although we observed an overall good adherence to CHEERS recommendations, there is still room for improvement in economic evaluations reporting in this field.

Klíčová slova:

colonoscopy – Health economics – Economics – Screening guidelines – Cost-effectiveness analysis – Database searching – Bibliometrics – Colorectal cancer

Zdroje

1. World Health Organization. Colorectal cancer Source: Globocan 2018 Number of new cases in 2018, both sexes, all ages [Internet]. 2018 [cited 30 May 2019]. Available: http://gco.iarc.fr/today/data/factsheets/cancers/10_8_9-Colorectum-fact-sheet.pdf

2. Amri R, Bordeianou LG, Sylla P, Berger DL. Impact of Screening Colonoscopy on Outcomes in Colon Cancer Surgery. JAMA Surg. 2013;148: 747–54. doi: 10.1001/jamasurg.2013.8 23784448

3. Moreno CC, Mittal PK, Sullivan PS, Rutherford R, Staley CA, Cardona K, et al. Colorectal Cancer Initial Diagnosis: Screening Colonoscopy, Diagnostic Colonoscopy, or Emergent Surgery, and Tumor Stage and Size at Initial Presentation. Clin Colorectal Cancer. 2016;15: 67–73. doi: 10.1016/j.clcc.2015.07.004 26602596

4. Wilkins T, McMechan D, Talukder A. Colorectal Cancer Screening and Prevention. Am Fam Physician. 2018;97: 658–665. 29763272

5. Garborg K, Holme O, Loberg M, Kalager M, Adami HO, Bretthauer M. Current status of screening for colorectal cancer. Ann Oncol. 2013;24: 1963–1972. doi: 10.1093/annonc/mdt157 23619033

6. Navarro M, Nicolas A, Ferrandez A, Lanas A. Colorectal cancer population screening programs worldwide in 2016: An update. World J Gastroenterol. 2017;23: 3632–3642. doi: 10.3748/wjg.v23.i20.3632 28611516

7. Bénard F, Barkun AN, Martel M, von Renteln D. Systematic review of colorectal cancer screening guidelines for average-risk adults: Summarizing the current global recommendations. World J Gastroenterol. 2018;24: 124–138. doi: 10.3748/wjg.v24.i1.124 29358889

8. Rex DK, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, et al. Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2017;112: 1016–1030. doi: 10.1038/ajg.2017.174 28555630

9. Canadian Task Force on Preventive Health Care. Recommendations on screening for colorectal cancer in primary care. Can Med Assoc J. 2016;188: 340–348.

10. Issa IA, Noureddine M. Colorectal cancer screening: An updated review of the available options. World J Gastroenterol. 2017;23: 5086. doi: 10.3748/wjg.v23.i28.5086 28811705

11. Sacristan JA, Ortun V, Rovira J, Prieto L, Garcia-Alonso F. [Economic assessment in medicine]. Med Clin. 2004;122: 379–382.

12. Catalá-López F, Ridao M, Alonso-Arroyo A, García-Altés A, Cameron C, González-Bermejo D, et al. The quality of reporting methods and results of cost-effectiveness analyses in Spain: A methodological systematic review. Syst Rev. 2016;5. doi: 10.1186/s13643-015-0182-4

13. Brown V, Diomedi BZ, Moodie M, Veerman JL, Carter R. A systematic review of economic analyses of active transport interventions that include physical activity benefits. Transp Policy. 2016;45: 190–208.

14. Bell CM, Urbach DR, Ray JG, Bayoumi A, Rosen AB, Greenberg D, et al. Bias in published cost effectiveness studies: Systematic review. British Medical Journal. 2006. pp. 699–701. doi: 10.1136/bmj.38737.607558.80 16495332

15. El Alili M, van Dongen JM, Huirne JAF, van Tulder MW, Bosmans JE. Reporting and Analysis of Trial-Based Cost-Effectiveness Evaluations in Obstetrics and Gynaecology. PharmacoEconomics. Springer International Publishing; 2017. pp. 1007–1033. doi: 10.1007/s40273-017-0531-3 28674846

16. Jeong KE, Cairns JA. Review of economic evidence in the prevention and early detection of colorectal cancer. Health Econ Rev. 2013;3: 20. doi: 10.1186/2191-1991-3-20 24229442

17. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009;6: e1000097. doi: 10.1371/journal.pmed.1000097 19621072

18. Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, et al. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Eur J Heal Econ. 2013;14: 367–372.

19. Jan van Eck N, Waltman L. VOSviewer Manual 1.6.5 [Internet]. 2016 [cited 18 Jul 2019]. Available: www.vosviewer.com.

20. van der Meulen MP, Lansdorp-Vogelaar I, Goede SL, Kuipers EJ, Dekker E, Stoker J, et al. Colorectal Cancer: Cost-effectiveness of Colonoscopy versus CT Colonography Screening with Participation Rates and Costs. Radiology. 2018;287: 901–911. doi: 10.1148/radiol.2017162359 29485322

21. Melnitchouk N, Soeteman DI, Davids JS, Fields A, Cohen J, Noubary F, et al. A Cost-effectiveness of colorectal cancer screening in Ukraine. Cost Eff Resour Alloc. 2018;16: 20. doi: 10.1186/s12962-018-0104-0 29977160

22. Chauvin P, Josselin J-MM, Heresbach D. Incremental net benefit and acceptability of alternative health policies: a case study of mass screening for colorectal cancer. Eur J Heal Econ. 2012;13: 237–250.

23. Sharp L, Tilson L, Whyte S, O’Ceilleachair A, Walsh C, Usher C, et al. Cost-effectiveness of population-based screening for colorectal cancer: a comparison of guaiac-based faecal occult blood testing, faecal immunochemical testing and flexible sigmoidoscopy. Br J Cancer. 2012;106: 805–816. doi: 10.1038/bjc.2011.580 22343624

24. Greuter MJE, De Klerk CM, Meijer GA, Dekker E, Coupé VMH, Coupe VMH. Screening for Colorectal Cancer With Fecal Immunochemical Testing With and Without Postpolypectomy Surveillance Colonoscopy. Ann Intern Med. 2017;167: 544. doi: 10.7326/M16-2891 28973514

25. Aronsson M, Carlsson P, Levin L-Å, Hager J, Hultcrantz R. Cost-effectiveness of high-sensitivity faecal immunochemical test and colonoscopy screening for colorectal cancer. Br J Surg. 2017;104: 1078–1086. doi: 10.1002/bjs.10536 28561259

26. Murphy J, Halloran S, Gray A. Cost-effectiveness of the faecal immunochemical test at a range of positivity thresholds compared with the guaiac faecal occult blood test in the NHS Bowel Cancer Screening Programme in England. BMJ Open. 2017;7: e017186. doi: 10.1136/bmjopen-2017-017186 29079605

27. Greuter MJE, Berkhof J, Fijneman RJA, Demirel E, Lew J-B, Meijer GA, et al. The potential of imaging techniques as a screening tool for colorectal cancer: a cost-effectiveness analysis. Br J Radiol. 2016;89: 20150910. doi: 10.1259/bjr.20150910 27194458

28. Ladabaum U, Alvarez-Osorio L, Rösch T, Brueggenjuergen B. Cost-effectiveness of colorectal cancer screening in Germany: current endoscopic and fecal testing strategies versus plasma methylated Septin 9 DNA. Endosc Int Open. 2014;02: E96–E104.

29. Lejeune C, Le Gleut K, Cottet V, Galimard C, Durand G, Dancourt V, et al. The cost-effectiveness of immunochemical tests for colorectal cancer screening. Dig Liver Dis. 2014;46: 76–81. doi: 10.1016/j.dld.2013.07.018 24012177

30. Goede SL, Van Roon AHCC, Reijerink JCIYIY, van Vuuren AJ, Lansdorp-Vogelaar I, Habbema JDF, et al. Cost-effectiveness of one versus two sample faecal immunochemical testing for colorectal cancer screening. Gut. 2013;62: 727–734. doi: 10.1136/gutjnl-2011-301917 22490518

31. Whyte S, Chilcott J, Halloran S, S. W, J. C. Reappraisal of the options for colorectal cancer screening in England. Color Dis. 2012;14: e547–e561.

32. Hassan C, Gralnek IM. Cost-effectiveness of “full spectrum endoscopy” colonoscopy for colorectal cancer screening. Dig Liver Dis. 2015;47: 390–394. doi: 10.1016/j.dld.2015.01.154 25704067

33. Hassan C, Rex DK, Zullo A, Kaminski MF. Efficacy and cost-effectiveness of screening colonoscopy according to the adenoma detection rate. United Eur Gastroenterol J. 2015;3: 200–207.

34. Dinh T, Ladabaum U, Alperin P, Caldwell C, Smith R, Levin TR. Health Benefits and Cost-effectiveness of a Hybrid Screening Strategy for Colorectal Cancer. Clin Gastroenterol Hepatol. 2013;11: 1158–1166. doi: 10.1016/j.cgh.2013.03.013 23542330

35. Pence BC, Belasco EJ, Lyford CP. Combination Aspirin and/or Calcium Chemoprevention with Colonoscopy in Colorectal Cancer Prevention: Cost-effectiveness Analyses. Cancer Epidemiol Biomarkers Prev. 2013;22: 399–405. doi: 10.1158/1055-9965.EPI-12-0658 23250933

36. Sharaf RN, Ladabaum U. Comparative Effectiveness and Cost-Effectiveness of Screening Colonoscopy vs. Sigmoidoscopy and Alternative Strategies. Am J Gastroenterol. 2013;108: 120–132. doi: 10.1038/ajg.2012.380 23247579

37. Ladabaum U, Allen J, Wandell M, Ramsey S. Colorectal Cancer Screening with Blood-Based Biomarkers: Cost-Effectiveness of Methylated Septin 9 DNA versus Current Strategies. Cancer Epidemiol Biomarkers Prev. 2013;22: 1567–1576. doi: 10.1158/1055-9965.EPI-13-0204 23796793

38. Hassan C, Rex DK, Cooper GS, Zullo A, Launois R, Benamouzig R. Primary prevention of colorectal cancer with low-dose aspirin in combination with endoscopy: a cost-effectiveness analysis. Gut. 2012;61: 1172–1179. doi: 10.1136/gutjnl-2011-300206 21997545

39. Ladabaum U, Mannalithara A. Comparative Effectiveness and Cost Effectiveness of a Multitarget Stool DNA Test to Screen for Colorectal Neoplasia. Gastroenterology. 2016;151: 427–439.e6. doi: 10.1053/j.gastro.2016.06.003 27311556

40. Wong MCS, Ching JYL, Chan VCW, Lam TYT, Luk AKC, Wong SH, et al. Colorectal Cancer Screening Based on Age and Gender. Medicine (Baltimore). 2016;95: e2739.

41. Wong CKKH, Lam CLLK, Wan YFY, Fong DYYT. Cost-effectiveness simulation and analysis of colorectal cancer screening in Hong Kong Chinese population: comparison amongst colonoscopy, guaiac and immunologic fecal occult blood testing. BMC Cancer. 2015;15: 705. doi: 10.1186/s12885-015-1730-y 26471036

42. Sekiguchi M, Igarashi A, Matsuda T, Matsumoto M, Sakamoto T, Nakajima T, et al. Optimal use of colonoscopy and fecal immunochemical test for population-based colorectal cancer screening: a cost-effectiveness analysis using Japanese data. Jpn J Clin Oncol. 2015;46: hyv186.

43. Huang W, Liu G, Zhang X, Fu W, Zheng S, Wu Q, et al. Cost-Effectiveness of Colorectal Cancer Screening Protocols in Urban Chinese Populations. Bruns H, editor. PLoS One. 2014;9: e109150. doi: 10.1371/journal.pone.0109150 25285526

44. Hashimoto Y, Igarashi A, Miyake M, Iinuma G, Fukuda T, Tsutani K. Cost-Effectiveness Analysis of CT Colonography for Colorectal Cancer Screening Program to Working Age in Japan. Value Heal Reg Issues. 2014;3: 182–189.

45. Barouni M, Ghaderi H, Shahmoradi MK, M. B, H. G, Barouni M, et al. The Economic Evaluation of Screening for Colorectal Cancer: Case of Iran. Clin Lab. 2013;59: 667–674. doi: 10.7754/clin.lab.2012.120812 23865368

46. Barouni M, Larizadeh MH, Sabermahani A, Ghaderi H. Markov’s Modeling for Screening Strategies for Colorectal Cancer. Asian Pacific J Cancer Prev. 2012;13: 5125–5129.

47. Wang Z-H, Gao Q-Y, Fang J-Y. Repeat colonoscopy every 10 years or single colonoscopy for colorectal neoplasm screening in average-risk Chinese: a cost-effectiveness analysis. Asian Pac J Cancer Prev. 2012;13: 1761–6. doi: 10.7314/apjcp.2012.13.5.1761 22901118

48. Pinzon Florez CE, Rosselli D, Gamboa Garay OA. Análisis de Costo-Efectividad de las Estrategias de Tamización de Cáncer Colorrectal en Colombia. Value Heal Reg Issues. 2012;1: 190–200.

49. Espinola N, Maceira D, Palacios A. Costo-efectividad de las pruebas de tamizaje del cáncer colorrectal en la Argentina. 2016;46: 8–17.

50. Goede SL, Rabeneck L, van Ballegooijen M, Zauber AG, Paszat LF, Hoch JS, et al. Harms, benefits and costs of fecal immunochemical testing versus guaiac fecal occult blood testing for colorectal cancer screening. Lu S-N, editor. PLoS One. 2017;12: e0172864. doi: 10.1371/journal.pone.0172864 28296927

51. Coldman A, Flanagan W, Nadeau C, Wolfson M, Fitzgerald N, Memon S, et al. Projected effect of fecal immunochemical test threshold for colorectal cancer screening on outcomes and costs for Canada using the OncoSim microsimulation model. J Cancer Policy. 2017;13: 38–46.

52. Lew J-B Bin, St. John DJB, Macrae FA, Emery JD, Ee HC, Jenkins MA, et al. Evaluation of the benefits, harms and cost-effectiveness of potential alternatives to iFOBT testing for colorectal cancer screening in Australia. Int J Cancer. 2018;143: 269–282. doi: 10.1002/ijc.31314 29441568

53. Brandeau ML. Modeling Complex Medical Decision Problems with the Archimedes Model. Ann Intern Med. 2005;143: 303. doi: 10.7326/0003-4819-143-4-200508160-00012 16103475

54. Imperiale TF, Kahi CJ, Rex DK. Lowering the Starting Age for Colorectal Cancer Screening to 45 Years: Who Will Come…and Should They? Clin Gastroenterol Hepatol. 2018;16: 1541–1544. doi: 10.1016/j.cgh.2018.08.023 30114484

55. Weinstein MC, O’Brien B, Hornberger J, Jackson J, Johannesson M, McCabe C, et al. Principles of Good Practice for Decision Analytic Modeling in Health-Care Evaluation: Report of the ISPOR Task Force on Good Research Practices—Modeling Studies. Value Heal. 2003;6: 9–17.

56. Health care systems in the European Union countries [Internet]. [cited 5 Dec 2019]. Available: https://www.mscbs.gob.es/estadEstudios/estadisticas/docs/presentacion_en.pdf

57. Rice T, Rosenau P, Unruh LY, Barnes AJ, Saltman RB, van Gineken E. United States of America: health system review. Health systems in transition. 2013. pp. 1–431.

58. Perisetti A, Khan H, George NE, Yendala R, Rafiq A, Blakely S, et al. Colorectal cancer screening use among insured adults: Is out-of-pocket cost a barrier to routine screening?. World J Gastrointest Pharmacol Ther. 2018;9: 31–38. doi: 10.4292/wjgpt.v9.i4.31 30191078

59. Patel SS, Kilgore ML. Cost Effectiveness of Colorectal Cancer Screening Strategies. Cancer Control. 2015;22: 248–258. doi: 10.1177/107327481502200219 26068773

60. Ran T, Cheng C-Y, Misselwitz B, Brenner H, Ubels J, Schlander M. Cost-Effectiveness of Colorectal Cancer Screening Strategies—A Systematic Review. Clin Gastroenterol Hepatol. 2019;17: 1969–1981.e15. doi: 10.1016/j.cgh.2019.01.014 30659991

61. Mannucci A, Zuppardo RA, Rosati R, Di Leo M, Perea J, Cavestro GM. Colorectal cancer screening from 45 years of age: Thesis, antithesis and synthesis. World Journal of Gastroenterology. Baishideng Publishing Group Co., Limited; 2019. pp. 2565–2580. doi: 10.3748/wjg.v25.i21.2565 31210710

62. Balchen V, Simon K. Colorectal cancer development and advances in screening. Clin Interv Aging. 2016;Volume 11: 967–976. doi: 10.2147/CIA.S109285 27486317

63. Kapidzic A, Grobbee EJ, Hol L, van Roon AH, van Vuuren AJ, Spijker W, et al. Attendance and Yield Over Three Rounds of Population-Based Fecal Immunochemical Test Screening. Am J Gastroenterol. 2014;109: 1257–1264. doi: 10.1038/ajg.2014.168 24980879