Economic evaluations of screening strategies for the early detection of colorectal cancer in the average-risk population: A systematic literature review.

<h4>Background</h4>Colorectal cancer (CRC) screening has proven effective in reducing CRC mortality. This study aimed to systematically review, and evaluate the reporting quality, of the economic evidence regarding CRC screening in average-risk individuals.<h4>Methods</h4>Dat...

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Main Authors: Joan Mendivil, Marilena Appierto, Susana Aceituno, Mercè Comas, Montserrat Rué
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0227251&type=printable
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author Joan Mendivil
Marilena Appierto
Susana Aceituno
Mercè Comas
Montserrat Rué
author_facet Joan Mendivil
Marilena Appierto
Susana Aceituno
Mercè Comas
Montserrat Rué
author_sort Joan Mendivil
collection DOAJ
description <h4>Background</h4>Colorectal cancer (CRC) screening has proven effective in reducing CRC mortality. This study aimed to systematically review, and evaluate the reporting quality, of the economic evidence regarding CRC screening in average-risk individuals.<h4>Methods</h4>Databases searched included Medline, EMBASE, National Health Service Economic Evaluation, Database of Abstracts of Reviews of Effects, Cost-Effectiveness Analysis registry, EconLit, and Health Technology Assessment database. Eligible studies were cost-effectiveness and cost-utility analyses comparing CRC screening strategies in average-risk individuals, published in English or Spanish, between January 2012 and November 2018. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.<h4>Results</h4>Of 1,993 publications initially retrieved, 477 were excluded by duplicate review, 1,449 by title/abstract review, and 34 by full-text review. Finally, 33 publications were included in the qualitative synthesis. Most studies were conducted in Europe (36,4%), followed by United States (24,2%) and Asia (24,2%). The main screening modalities considered were fecal immunochemical tests (70%), colonoscopy (67%), guaiac fecal occult blood test (42%) and flexible sigmoidoscopy (30%). In most studies, CRC screening was deemed cost-effective compared to no screening. Sensitivity analyses indicated that cost of CRC screening tests, adherence to screening, screening test sensitivity, and cost of CRC treatment had the greatest impact on cost-effectiveness results across studies. The majority of studies (73%) adequately reported at least 50% of the items included in the CHEERS checklist. Least well reported items included setting, study perspective, discount rate, model choice, and methods to identify effectiveness data or to estimate resource use and costs.<h4>Conclusions</h4>CRC screening is an efficient alternative to no screening. Nevertheless, it is not possible to conclude which strategy should be preferred for population-based screening programs. Although we observed an overall good adherence to CHEERS recommendations, there is still room for improvement in economic evaluations reporting in this field.
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spelling doaj-art-4af82a524d6e4db1837791c799adc8ca2025-08-20T02:00:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011412e022725110.1371/journal.pone.0227251Economic evaluations of screening strategies for the early detection of colorectal cancer in the average-risk population: A systematic literature review.Joan MendivilMarilena AppiertoSusana AceitunoMercè ComasMontserrat Rué<h4>Background</h4>Colorectal cancer (CRC) screening has proven effective in reducing CRC mortality. This study aimed to systematically review, and evaluate the reporting quality, of the economic evidence regarding CRC screening in average-risk individuals.<h4>Methods</h4>Databases searched included Medline, EMBASE, National Health Service Economic Evaluation, Database of Abstracts of Reviews of Effects, Cost-Effectiveness Analysis registry, EconLit, and Health Technology Assessment database. Eligible studies were cost-effectiveness and cost-utility analyses comparing CRC screening strategies in average-risk individuals, published in English or Spanish, between January 2012 and November 2018. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.<h4>Results</h4>Of 1,993 publications initially retrieved, 477 were excluded by duplicate review, 1,449 by title/abstract review, and 34 by full-text review. Finally, 33 publications were included in the qualitative synthesis. Most studies were conducted in Europe (36,4%), followed by United States (24,2%) and Asia (24,2%). The main screening modalities considered were fecal immunochemical tests (70%), colonoscopy (67%), guaiac fecal occult blood test (42%) and flexible sigmoidoscopy (30%). In most studies, CRC screening was deemed cost-effective compared to no screening. Sensitivity analyses indicated that cost of CRC screening tests, adherence to screening, screening test sensitivity, and cost of CRC treatment had the greatest impact on cost-effectiveness results across studies. The majority of studies (73%) adequately reported at least 50% of the items included in the CHEERS checklist. Least well reported items included setting, study perspective, discount rate, model choice, and methods to identify effectiveness data or to estimate resource use and costs.<h4>Conclusions</h4>CRC screening is an efficient alternative to no screening. Nevertheless, it is not possible to conclude which strategy should be preferred for population-based screening programs. Although we observed an overall good adherence to CHEERS recommendations, there is still room for improvement in economic evaluations reporting in this field.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0227251&type=printable
spellingShingle Joan Mendivil
Marilena Appierto
Susana Aceituno
Mercè Comas
Montserrat Rué
Economic evaluations of screening strategies for the early detection of colorectal cancer in the average-risk population: A systematic literature review.
PLoS ONE
title Economic evaluations of screening strategies for the early detection of colorectal cancer in the average-risk population: A systematic literature review.
title_full Economic evaluations of screening strategies for the early detection of colorectal cancer in the average-risk population: A systematic literature review.
title_fullStr Economic evaluations of screening strategies for the early detection of colorectal cancer in the average-risk population: A systematic literature review.
title_full_unstemmed Economic evaluations of screening strategies for the early detection of colorectal cancer in the average-risk population: A systematic literature review.
title_short Economic evaluations of screening strategies for the early detection of colorectal cancer in the average-risk population: A systematic literature review.
title_sort economic evaluations of screening strategies for the early detection of colorectal cancer in the average risk population a systematic literature review
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0227251&type=printable
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