The Cost‐Effectiveness of a Multi‐Target Stool DNA‐Based Screening (COLOTECT), FIT, Colonoscopy and No Screening for Colorectal Cancer

ABSTRACT Background Around 1.9 million new cases and 1 million deaths worldwide were attributed to colorectal cancer (CRC) in 2020. Aims The aims of this study are to assess the cost‐effectiveness of a multi‐target stool DNA‐based screening strategy, COLOTECT, compared to faecal immunochemical tests...

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Main Authors: Junjie Huang, Mingtao Chen, Victor C. W. Chan, Xianjing Liu, Chaoying Zhong, Jianli Lin, Junjie Hang, Claire Chenwen Zhong, Jinqiu Yuan, Martin C. S. Wong
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Cancer Reports
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Online Access:https://doi.org/10.1002/cnr2.70176
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author Junjie Huang
Mingtao Chen
Victor C. W. Chan
Xianjing Liu
Chaoying Zhong
Jianli Lin
Junjie Hang
Claire Chenwen Zhong
Jinqiu Yuan
Martin C. S. Wong
author_facet Junjie Huang
Mingtao Chen
Victor C. W. Chan
Xianjing Liu
Chaoying Zhong
Jianli Lin
Junjie Hang
Claire Chenwen Zhong
Jinqiu Yuan
Martin C. S. Wong
author_sort Junjie Huang
collection DOAJ
description ABSTRACT Background Around 1.9 million new cases and 1 million deaths worldwide were attributed to colorectal cancer (CRC) in 2020. Aims The aims of this study are to assess the cost‐effectiveness of a multi‐target stool DNA‐based screening strategy, COLOTECT, compared to faecal immunochemical tests (FIT), colonoscopy, and no screening in the Asian population to inform more choices for policymakers in colorectal cancer screening. Method and Results We assume that 100,000 persons aged 50 undergo annual FIT, annual COLOTECT multi‐target testing, or colonoscopies every 10 years until age 75. The data used in this study was retrieved from different sources including the Hong Kong Cancer Registry and previously published studies on the population aged 50 to 75 years old between 2010 and 2023. This study accessed the most cost‐effective screening strategy available. If a positive result of FIT or COLOTECT were observed, the participants would undergo a colonoscopy. The participants who used the colonoscopy as the main screening method conducted colonoscopies every 3 years. The Markov models were utilized to compare the outcomes from different strategies including life‐years saved, years of life lost, and incremental cost‐effectiveness ratio (primary outcome). The highest ICER was observed in colonoscopy (USD 160808), followed by FIT (USD 108952), and COLOTECT (USD 82206). A higher detection rate of CRC (COLOTECT: 39.3% vs. FIT: 4.5%), more CRC cases prevented (1272 vs. 146), and life‐years saved (2295 vs. 337) were observed in the COLOTECT strategy than in FIT. Additionally, a lower total cost per life‐year saved of COLOTECT (USD 180097) was observed than colonoscopy (USD 238356), which identified the more affordable and cost‐saving COLOTECT strategy. Conclusion This study highlighted the better performance of COLOTECT than FIT in detecting CRC. Additionally, given its lower cost and higher acceptance, the COLOTECT strategy might be more cost‐effective than colonoscopy for massive CRC screening.
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spelling doaj-art-0f0c679d98344564896c729f312cd34e2025-08-20T03:53:23ZengWileyCancer Reports2573-83482025-04-0184n/an/a10.1002/cnr2.70176The Cost‐Effectiveness of a Multi‐Target Stool DNA‐Based Screening (COLOTECT), FIT, Colonoscopy and No Screening for Colorectal CancerJunjie Huang0Mingtao Chen1Victor C. W. Chan2Xianjing Liu3Chaoying Zhong4Jianli Lin5Junjie Hang6Claire Chenwen Zhong7Jinqiu Yuan8Martin C. S. Wong9Jockey Club School of Public Health and Primary Care, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SARJockey Club School of Public Health and Primary Care, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SARJockey Club School of Public Health and Primary Care, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SARDepartment of Radiology and Nuclear Medicine Erasmus MC University Medical Center Rotterdam the NetherlandsDepartment of Electrical Engineering and Automation Guangdong Ocean University Zhanjiang Guangdong ChinaPeking‐Tsinghua Center for Life Sciences Academy for Advanced Interdisciplinary Studies, Peking University Beijing ChinaCancer Hospital & Shenzhen Hospital Beijing Chinese Academy of Medical Sciences and Peking Union Medical College ChinaJockey Club School of Public Health and Primary Care, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SARClinical Research Center, Big Data Center The Seventh Afliated Hospital, Sun Yat‐Sen University Guangzhou Guangdong ChinaJockey Club School of Public Health and Primary Care, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SARABSTRACT Background Around 1.9 million new cases and 1 million deaths worldwide were attributed to colorectal cancer (CRC) in 2020. Aims The aims of this study are to assess the cost‐effectiveness of a multi‐target stool DNA‐based screening strategy, COLOTECT, compared to faecal immunochemical tests (FIT), colonoscopy, and no screening in the Asian population to inform more choices for policymakers in colorectal cancer screening. Method and Results We assume that 100,000 persons aged 50 undergo annual FIT, annual COLOTECT multi‐target testing, or colonoscopies every 10 years until age 75. The data used in this study was retrieved from different sources including the Hong Kong Cancer Registry and previously published studies on the population aged 50 to 75 years old between 2010 and 2023. This study accessed the most cost‐effective screening strategy available. If a positive result of FIT or COLOTECT were observed, the participants would undergo a colonoscopy. The participants who used the colonoscopy as the main screening method conducted colonoscopies every 3 years. The Markov models were utilized to compare the outcomes from different strategies including life‐years saved, years of life lost, and incremental cost‐effectiveness ratio (primary outcome). The highest ICER was observed in colonoscopy (USD 160808), followed by FIT (USD 108952), and COLOTECT (USD 82206). A higher detection rate of CRC (COLOTECT: 39.3% vs. FIT: 4.5%), more CRC cases prevented (1272 vs. 146), and life‐years saved (2295 vs. 337) were observed in the COLOTECT strategy than in FIT. Additionally, a lower total cost per life‐year saved of COLOTECT (USD 180097) was observed than colonoscopy (USD 238356), which identified the more affordable and cost‐saving COLOTECT strategy. Conclusion This study highlighted the better performance of COLOTECT than FIT in detecting CRC. Additionally, given its lower cost and higher acceptance, the COLOTECT strategy might be more cost‐effective than colonoscopy for massive CRC screening.https://doi.org/10.1002/cnr2.70176colorectal cancercost‐effectivenessmulti‐target stool DNAnon‐invasive biomarkerscreening
spellingShingle Junjie Huang
Mingtao Chen
Victor C. W. Chan
Xianjing Liu
Chaoying Zhong
Jianli Lin
Junjie Hang
Claire Chenwen Zhong
Jinqiu Yuan
Martin C. S. Wong
The Cost‐Effectiveness of a Multi‐Target Stool DNA‐Based Screening (COLOTECT), FIT, Colonoscopy and No Screening for Colorectal Cancer
Cancer Reports
colorectal cancer
cost‐effectiveness
multi‐target stool DNA
non‐invasive biomarker
screening
title The Cost‐Effectiveness of a Multi‐Target Stool DNA‐Based Screening (COLOTECT), FIT, Colonoscopy and No Screening for Colorectal Cancer
title_full The Cost‐Effectiveness of a Multi‐Target Stool DNA‐Based Screening (COLOTECT), FIT, Colonoscopy and No Screening for Colorectal Cancer
title_fullStr The Cost‐Effectiveness of a Multi‐Target Stool DNA‐Based Screening (COLOTECT), FIT, Colonoscopy and No Screening for Colorectal Cancer
title_full_unstemmed The Cost‐Effectiveness of a Multi‐Target Stool DNA‐Based Screening (COLOTECT), FIT, Colonoscopy and No Screening for Colorectal Cancer
title_short The Cost‐Effectiveness of a Multi‐Target Stool DNA‐Based Screening (COLOTECT), FIT, Colonoscopy and No Screening for Colorectal Cancer
title_sort cost effectiveness of a multi target stool dna based screening colotect fit colonoscopy and no screening for colorectal cancer
topic colorectal cancer
cost‐effectiveness
multi‐target stool DNA
non‐invasive biomarker
screening
url https://doi.org/10.1002/cnr2.70176
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