5th Asia-Pacific Summit on Cancer Therapy
Harbin Medical University, China
Title: Cost-effectiveness of colorectal cancer screening protocols in urban Chinese populations
Biography: Guoxiang Liu
CRC takes a second and fourth position in the incidence and mortality lists respectively among all malignant tumors in urban populations in China. Effective early detection and prevention of Colorectal Cancer (CRC) were successfully achieved and confirmed by large-scale randomized controlled trials of CRC screening. The project “Comparison and Evaluation of Screening Programs for Colorectal Cancer in Urban Communities in China” (CESP) was undertaken from July 2006 to December 2008 in China. Based on the CESP project, this study was designed to evaluate the cost-effectiveness of two different CRC screening protocols: Fecal occult blood test (FOBT) alone and FOBT plus a high-risk factor questionnaire (HRFQ) as the respective initial screens followed by colonoscopy. We developed a Markov model to simulate the progression of a cohort of 100,000 average risk asymptomatic individuals moving through a defined series of states between the ages of 40 to 74 years. The study revealed that a combined use of FOBT and HRFQ is preferable in CRC screening programs as an initial screening instrument. Annual FOBT+HRFQ screening is recommended for those who have a negative initial result and those who have a positive result but have failed to continue to colonoscopic examination. Repeated colonoscopy (for those with a negative colonoscopy result) should be performed at a ten-year interval instead of one-year. Such a protocol would cost 7732 Yuan per life year saved which is the most cost-effective option. These results provide helpful experiences and references for current national CRC screening projects in China.