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Is population screening for colorectal cancer cost-effective?

Nature Clinical Practice Gastroenterology & Hepatology volume 2, pages 288–289 (2005)Cite this article

Colorectal cancer (CRC) is a major cause of morbidity and mortality in the US and worldwide. Data from the American Cancer Society suggest that, in 2005, over 145,000 people in the US will develop CRC and over 56,000 will die from this disease.1 Furthermore, the WHO recently estimated that 945,000 new cases of CRC and 492,000 CRC-related deaths will occur annually worldwide.2 A person's lifetime risk of CRC is 5–6%. The majority (>60%) of CRC is detected at the nonlocalized stage, and the 5-year survival rate is only 64% in the US and even lower in other countries.1

Fortunately, CRC and CRC-related mortality are preventable. Randomized trials suggest that screening with fecal occult blood testing (FOBT) in adults over 50 years of age can reduce the incidence of CRC by 17–20% and CRC mortality by 16–33%.3,4 Case-control studies suggest that other screening methods, such as sigmoidoscopy or colonoscopy, are also effective;4 however, these methods have not yet been compared in head-to-head studies. Moreover, screening is currently underutilized in the US: up-to-date screening has reportedly been carried out in only ∼50% of age-eligible adults.1

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References

  1. American Cancer Society (2005) Colorectal Cancer Facts and Figures Special Edition 2005. Atlanta: American Cancer Society

  2. International Agency for Research on Cancer (2003) World Cancer Report. (Eds Stewart BW and Kleihues P) Geneva: World Health Organization Press

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  1. Associate Professor of Medicine, University of North Carolina, Chapel Hill, NC, USA

    Michael Pignone

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  1. Michael Pignone
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Correspondence to Michael Pignone.

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The author declares no competing financial interests.

Glossary

CREDIBLE INTERVALS

The Bayesian statistical equivalent of confidence intervals

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Pignone, M. Is population screening for colorectal cancer cost-effective?. Nat Rev Gastroenterol Hepatol 2, 288–289 (2005). https://doi.org/10.1038/ncpgasthep0216

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