Cost-effectiveness of colorectal cancer screening in Ukraine
Abstract Background Colorectal cancer is one of the most common cancers worldwide and is associated with high mortality when detected at a later stage. There is a paucity of studies from low and middle income countries to support the cost-effectiveness of colorectal cancer screening. We aim to analy...
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doaj-f40f2d2009ad4eb5bd0d667c6973489f2020-11-25T00:23:36ZengBMCCost Effectiveness and Resource Allocation1478-75472018-06-011611910.1186/s12962-018-0104-0Cost-effectiveness of colorectal cancer screening in UkraineNelya Melnitchouk0Djøra I. Soeteman1Jennifer S. Davids2Adam Fields3Joshua Cohen4Farzad Noubary5Andrey Lukashenko6Olena O. Kolesnik7Karen M. Freund8Department of Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital/Harvard Medical SchoolCenter for Health Decision Science, Harvard T.H. Chan School of Public HealthUMass Medical CenterDepartment of Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital/Harvard Medical SchoolTufts Clinical and Translational Science InstituteTufts Clinical and Translational Science InstituteNational Cancer InstituteNational Cancer InstituteTufts Medical Center and Tufts University School of Medicine BostonAbstract Background Colorectal cancer is one of the most common cancers worldwide and is associated with high mortality when detected at a later stage. There is a paucity of studies from low and middle income countries to support the cost-effectiveness of colorectal cancer screening. We aim to analyze the cost-effectiveness of colorectal cancer screening compared to no screening in Ukraine, a lower-middle income country. Methods We developed a deterministic Markov cohort model to assess the cost-effectiveness of three colorectal cancer screening strategies [fecal occult blood test (FOBT) every year, flexible sigmoidoscopy with FOBT every 5 years, and colonoscopy every 10 years] compared to no screening. We modeled outcomes in terms of cost per quality-adjusted life-years (QALYs) over a lifetime time horizon. We performed sensitivity analyses on treatment adherence, test characteristics and costs. Analyses were conducted from the perspective of the Ministry of Health of Ukraine. Results The base-case lifetime cost-effectiveness analysis showed that all three screening strategies were cost saving compared to no screening, and among the three strategies, colonoscopy every 10 years was the dominant strategy compared to no screening with standard adherence to treatment. When decreased adherence to treatment was modeled, colonoscopy every 10 years was the most cost-effective strategy with an incremental cost-effectiveness ratio of $843 per QALY compared with no screening. Conclusion Our findings indicate that colorectal cancer screening can save money and improve health compared to no screening in Ukraine. Colonoscopy every 10 years is superior to the other screening modalities evaluated in this study. This knowledge can be used to concentrate efforts on developing a national screening program in Ukraine.http://link.springer.com/article/10.1186/s12962-018-0104-0 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nelya Melnitchouk Djøra I. Soeteman Jennifer S. Davids Adam Fields Joshua Cohen Farzad Noubary Andrey Lukashenko Olena O. Kolesnik Karen M. Freund |
spellingShingle |
Nelya Melnitchouk Djøra I. Soeteman Jennifer S. Davids Adam Fields Joshua Cohen Farzad Noubary Andrey Lukashenko Olena O. Kolesnik Karen M. Freund Cost-effectiveness of colorectal cancer screening in Ukraine Cost Effectiveness and Resource Allocation |
author_facet |
Nelya Melnitchouk Djøra I. Soeteman Jennifer S. Davids Adam Fields Joshua Cohen Farzad Noubary Andrey Lukashenko Olena O. Kolesnik Karen M. Freund |
author_sort |
Nelya Melnitchouk |
title |
Cost-effectiveness of colorectal cancer screening in Ukraine |
title_short |
Cost-effectiveness of colorectal cancer screening in Ukraine |
title_full |
Cost-effectiveness of colorectal cancer screening in Ukraine |
title_fullStr |
Cost-effectiveness of colorectal cancer screening in Ukraine |
title_full_unstemmed |
Cost-effectiveness of colorectal cancer screening in Ukraine |
title_sort |
cost-effectiveness of colorectal cancer screening in ukraine |
publisher |
BMC |
series |
Cost Effectiveness and Resource Allocation |
issn |
1478-7547 |
publishDate |
2018-06-01 |
description |
Abstract Background Colorectal cancer is one of the most common cancers worldwide and is associated with high mortality when detected at a later stage. There is a paucity of studies from low and middle income countries to support the cost-effectiveness of colorectal cancer screening. We aim to analyze the cost-effectiveness of colorectal cancer screening compared to no screening in Ukraine, a lower-middle income country. Methods We developed a deterministic Markov cohort model to assess the cost-effectiveness of three colorectal cancer screening strategies [fecal occult blood test (FOBT) every year, flexible sigmoidoscopy with FOBT every 5 years, and colonoscopy every 10 years] compared to no screening. We modeled outcomes in terms of cost per quality-adjusted life-years (QALYs) over a lifetime time horizon. We performed sensitivity analyses on treatment adherence, test characteristics and costs. Analyses were conducted from the perspective of the Ministry of Health of Ukraine. Results The base-case lifetime cost-effectiveness analysis showed that all three screening strategies were cost saving compared to no screening, and among the three strategies, colonoscopy every 10 years was the dominant strategy compared to no screening with standard adherence to treatment. When decreased adherence to treatment was modeled, colonoscopy every 10 years was the most cost-effective strategy with an incremental cost-effectiveness ratio of $843 per QALY compared with no screening. Conclusion Our findings indicate that colorectal cancer screening can save money and improve health compared to no screening in Ukraine. Colonoscopy every 10 years is superior to the other screening modalities evaluated in this study. This knowledge can be used to concentrate efforts on developing a national screening program in Ukraine. |
url |
http://link.springer.com/article/10.1186/s12962-018-0104-0 |
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