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Tytuł:
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Modeling costs and benefits of the organized colorectal cancer screening programme and its potential future improvements in Hungary.
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Autorzy:
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Csanádi M; Syreon Research Institute, Budapest, Hungary.
Gini A; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Koning H; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Széles G; Syreon Research Institute, Budapest, Hungary.
Pitter JG; Syreon Research Institute, Budapest, Hungary.
Oroszi B; National Public Health Institute, Budapest, Hungary.
Pataki P; National Public Health Institute, Budapest, Hungary.
Fadgyas-Freyler P; National Health Insurance Fund of Hungary, Budapest, Hungary.
Korponai G; National Health Insurance Fund of Hungary, Budapest, Hungary.
Vokó Z; Syreon Research Institute, Budapest, Hungary.; Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary.
Lansdorp-Vogelaar I; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
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Źródło:
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Journal of medical screening [J Med Screen] 2021 Sep; Vol. 28 (3), pp. 268-276. Date of Electronic Publication: 2020 Nov 05.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Dec. 2012- : London : Sage
Original Publication: London : BMJ Publishing Group, c1994-
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MeSH Terms:
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Colorectal Neoplasms*/diagnosis
Early Detection of Cancer*
Colonoscopy ; Cost-Benefit Analysis ; Humans ; Hungary ; Mass Screening ; Occult Blood
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Contributed Indexing:
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Keywords: Colorectal cancer screening; costs and benefits; economic evaluation; national screening programme
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Entry Date(s):
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Date Created: 20201106 Date Completed: 20211004 Latest Revision: 20211004
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Update Code:
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20240105
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DOI:
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10.1177/0969141320968598
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PMID:
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33153369
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Objective: The national population-based colorectal cancer screening programme in Hungary was initiated in December 2018. We aimed to evaluate the current programme and investigate the costs and benefits of potential future changes to overcome the low coverage of the target population.
Methods: We performed an economic evaluation from a healthcare payer perspective using an established micro-simulation model (Microsimulation Screening Analysis-Colon). We simulated costs and benefits of screening with fecal immunochemical test in the Hungarian population aged 50-100, investigating also the impact of potential future scenarios which were assumed to increase invitation coverage: improvement of the IT platform currently used by GPs or distributing the tests through pharmacies instead of GPs.
Results: The model predicted that the current screening programme could lead to 6.2% colorectal cancer mortality reduction between 2018 and 2050 compared to no screening. Even higher reductions, up to 16.6%, were estimated when tests were distributed through pharmacies and higher coverage was assumed. This change in the programme was estimated to require up to 26 million performed fecal immunochemical tests and 1 million colonoscopies for the simulated period. These future scenarios have acceptable cost-benefit ratios of €8000-€8700 per life-years gained depending on the assumed adherence of invited individuals.
Conclusions: With its limitations, the current colorectal cancer screening programme in Hungary will have a modest impact on colorectal cancer mortality. Significant improvements in mortality reduction could be made at acceptable costs, if the tests were to be distributed by pharmacies allowing the entire target population to be invited.
