Nur Amrizal Muhammad, Aljunid Syed Mohamed, Tolma Eleni L, Annaka Mahmoud, Alwotayan Rihab, Elbasmi Amani, Alali Walid Q
PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei Darussalam.
Department of Health Policy and Management, College of Public Health, Health Sciences Center, Kuwait University, Shadadiya, Kuwait.
Sci Rep. 2025 Mar 1;15(1):7354. doi: 10.1038/s41598-025-91119-4.
Colorectal cancer (CRC) poses a significant health challenge in Kuwait, ranking as the second most common cancer with the incidence rate 13.2 cases per 100,000 people in year 2019. This study aims to determine the cost-effectiveness of three colorectal cancer (CRC) screening methods in Kuwait from the perspective of Kuwait's healthcare providers. Using a Decision Tree Analysis Model, the study compared three screening modalities: Fecal Occult Blood Test (FOBT) followed by colonoscopy or sigmoidoscopy, colonoscopy alone, sigmoidoscopy alone and alongside no screening. Over a 10-year period post-diagnosis, the model tracked costs and outcomes based on CRC patients' life expectancy, expressing results using Incremental Cost Effectiveness Ratios (ICERs). Colorectal cancer screening using FOBT followed by colonoscopy or sigmoidoscopy resulted in 7.7 quality-adjusted life years (QALYs) at a cost of USD 3,573. In contrast, no screening achieved 7.2 QALYs but was more expensive, costing USD 4,084. Screening with only sigmoidoscopy or only colonoscopy provided 6.8 QALYs each, at costs of USD 4,905 and USD 5,002, respectively. Sensitivity analyses explored uncertainties in cost and outcome estimates. FOBT followed by colonoscopy or sigmoidoscopy can be considered as an efficient and effective approach towards early detection of CRC. This approach can be used by healthcare policymakers in Kuwait, in the development of population-based CRC screening programs to optimize resource allocation and improve public health outcomes.
在科威特，结直肠癌（CRC）对健康构成了重大挑战，它是第二大常见癌症，2019年的发病率为每10万人中有13.2例。本研究旨在从科威特医疗服务提供者的角度确定三种结直肠癌（CRC）筛查方法的成本效益。该研究使用决策树分析模型，比较了三种筛查方式：粪便潜血试验（FOBT）后进行结肠镜检查或乙状结肠镜检查、单独进行结肠镜检查、单独进行乙状结肠镜检查以及不进行筛查。在诊断后的10年期间，该模型根据CRC患者的预期寿命跟踪成本和结果，并使用增量成本效益比（ICER）来表达结果。采用FOBT后进行结肠镜检查或乙状结肠镜检查的结直肠癌筛查可带来7.7个质量调整生命年（QALY），成本为3573美元。相比之下，不进行筛查可获得7.2个QALY，但成本更高，为4084美元。仅进行乙状结肠镜检查或仅进行结肠镜检查的筛查分别带来6.8个QALY，成本分别为4905美元和5002美元。敏感性分析探讨了成本和结果估计中的不确定性。FOBT后进行结肠镜检查或乙状结肠镜检查可被视为早期检测CRC的一种高效且有效的方法。科威特的医疗政策制定者可采用这种方法来制定基于人群的CRC筛查计划，以优化资源分配并改善公共卫生结果。
