Subramanian Sujha, Tangka Florence K L, Hoover Sonja, Royalty Janet, DeGroff Amy, Joseph Djenaba
RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452, USA.
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA.
Eval Program Plann. 2017 Jun;62:73-80. doi: 10.1016/j.evalprogplan.2017.02.007. Epub 2017 Feb 7.
We assess annual costs of screening provision activities implemented by 23 of the Centers for Disease Control and Prevention's Colorectal Cancer Control Program (CRCCP) grantees and report differences in costs between colonoscopy and FOBT/FIT-based screening programs. We analysed annual cost data for the first three years of the CRCCP (July 2009-June 2011) for each screening provision activity and categorized them into clinical and non-clinical screening provision activities. The largest cost components for both colonoscopy and FOBT/FIT-based programs were screening and diagnostic services, program management, and data collection and tracking. During the first 3 years of the CRCCP, the average annual clinical cost for screening and diagnostic services per person served was $1150 for colonoscopy programs, compared to $304 for FIT/FOBT-based programs. Overall, FOBT/FIT-based programs appear to have slightly higher non-clinical costs per person served (average $1018; median $838) than colonoscopy programs (average $980; median $686). Colonoscopy-based CRCCP programs have higher clinical costs than FOBT/FIT-based programs during the 3-year study timeframe (translating into fewer people screened). Non-clinical costs for both approaches are similar and substantial. Future studies of the cost-effectiveness of colorectal cancer screening initiatives should consider both clinical and non-clinical costs.
我们评估了疾病控制与预防中心（CDC）的23个结直肠癌控制项目（CRCCP）受资助方开展的筛查活动的年度成本，并报告了结肠镜检查与基于粪便潜血试验（FOBT）/粪便免疫化学试验（FIT）的筛查项目之间的成本差异。我们分析了CRCCP前三年（2009年7月至2011年6月）每项筛查活动的年度成本数据，并将其分为临床和非临床筛查活动。结肠镜检查和基于FOBT/FIT的项目中最大的成本组成部分是筛查和诊断服务、项目管理以及数据收集与跟踪。在CRCCP的前三年中，结肠镜检查项目中每人每年的筛查和诊断服务平均临床成本为1150美元，而基于FIT/FOBT的项目为304美元。总体而言，基于FOBT/FIT的项目似乎比结肠镜检查项目每人的非临床成本略高（平均1018美元；中位数838美元）（结肠镜检查项目平均980美元；中位数686美元）。在为期3年的研究期间，基于结肠镜检查的CRCCP项目的临床成本高于基于FOBT/FIT的项目（这意味着筛查的人数更少）。两种方法的非临床成本相似且数额巨大。未来关于结直肠癌筛查举措成本效益的研究应同时考虑临床和非临床成本。
