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Cost Effectiveness of Colorectal Cancer Screening Interventions with Their Effects on Health Disparity Being Considered

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Názov: Cost Effectiveness of Colorectal Cancer Screening Interventions with Their Effects on Health Disparity Being Considered
Autori: Kwang Sig Lee, Eun Cheol Park
Prispievatelia: College of Medicine, Dept. of Preventive Medicine, Kwang-Sig Lee, Eun-Cheol Park, Park, Eun Chul
Zdroj: Cancer Res Treat
Informácie o vydavateľovi: Korean Cancer Association, 2016.
Rok vydania: 2016
Predmety: Biopsy, Cost-Benefit Analysis, Early Detection of Cancer/economics, Health Status Disparities, Colorectal neoplasms, Colorectal Neoplasms/diagnosis, Occult Blood, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Mass Screening/methods, Mass Screening/economics, Humans, Mass Screening, Healthcare Disparities/economics, Healthcare Disparities, 10. No inequality, Early Detection of Cancer, Aged, Colorectal Neoplasms/pathology, Cost-benefit analysis, Colonoscopy/economics, Mass screening, Colonoscopy, Middle Aged, Markov Chains, 3. Good health, Colorectal Neoplasms/economics, Socioeconomic Factors, Colorectal Neoplasms/therapy, Health status disparities, Original Article, Quality-Adjusted Life Years, Early Detection of Cancer/methods, Colorectal Neoplasms
Popis: The purpose of this study was to evaluate the cost effectiveness of colorectal cancer screening interventions with their effects on health disparity being considered.Markov cohort simulation was conducted with the cycle/duration of 1/40 year(s). Data came from the results of randomized trials and others. Participants were hypothetical cohorts aged 50 years as of year 2013 in 16 Korean provinces. The interventions until the age of 80 were annual organized fecal occult blood test (FOBT) (standard screening), annual FOBT with basic reminders for provinces with higher mortalities than the national average (targeted reminder) and annual FOBT with basic/enhanced reminders for all provinces (universal reminder 1 and 2). The comparison was non-screening, the outcome was quality-adjusted life years, and only medical costs for screening and treatment were considered from a societal perspective. The Atkinson incremental cost effectiveness ratio (Atkinson ICER), the incremental cost effectiveness ratio adjusted by the Atkinson Inequality Index, was used to evaluate the cost effectiveness of the four interventions with their impacts on regional health disparity being considered.Health disparity was smallest (or greatest) in non-screening (or the standard screening). The targeted reminder had smaller health disparity, and smaller Atkinson ICER with respect to standard screening, than did the universal reminder 1 and 2.The targeted reminder might be more cost effective than the universal reminders with their effects on health disparity being considered. This study helps to develop promotional effort for colorectal cancer screening with both the greatest cost effectiveness and the smallest health disparity.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 2005-9256
1598-2998
DOI: 10.4143/crt.2015.279
Prístupová URL adresa: http://www.e-crt.org/upload/pdf/crt-2015-279.pdf
https://pubmed.ncbi.nlm.nih.gov/26727714
https://pubmed.ncbi.nlm.nih.gov/26727714/
http://www.e-crt.org/upload/pdf/crt-2015-279.pdf
https://www.ncbi.nlm.nih.gov/pubmed/26727714
https://www.e-crt.org/journal/view.php?doi=10.4143/crt.2015.279
https://www.e-sciencecentral.org/articles/SC000015998
http://europepmc.org/articles/PMC4946354
Rights: CC BY NC
CC BY NC ND
Prístupové číslo: edsair.doi.dedup.....0077e77f83f8027510b65a27a5efd5bd
Databáza: OpenAIRE
Popis
Abstrakt:The purpose of this study was to evaluate the cost effectiveness of colorectal cancer screening interventions with their effects on health disparity being considered.Markov cohort simulation was conducted with the cycle/duration of 1/40 year(s). Data came from the results of randomized trials and others. Participants were hypothetical cohorts aged 50 years as of year 2013 in 16 Korean provinces. The interventions until the age of 80 were annual organized fecal occult blood test (FOBT) (standard screening), annual FOBT with basic reminders for provinces with higher mortalities than the national average (targeted reminder) and annual FOBT with basic/enhanced reminders for all provinces (universal reminder 1 and 2). The comparison was non-screening, the outcome was quality-adjusted life years, and only medical costs for screening and treatment were considered from a societal perspective. The Atkinson incremental cost effectiveness ratio (Atkinson ICER), the incremental cost effectiveness ratio adjusted by the Atkinson Inequality Index, was used to evaluate the cost effectiveness of the four interventions with their impacts on regional health disparity being considered.Health disparity was smallest (or greatest) in non-screening (or the standard screening). The targeted reminder had smaller health disparity, and smaller Atkinson ICER with respect to standard screening, than did the universal reminder 1 and 2.The targeted reminder might be more cost effective than the universal reminders with their effects on health disparity being considered. This study helps to develop promotional effort for colorectal cancer screening with both the greatest cost effectiveness and the smallest health disparity.
ISSN:20059256
15982998
DOI:10.4143/crt.2015.279