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COST-EFFECTIVENESS OF AN ADVANCE NOTIFICATION LETTER TO INCREASE COLORECTAL CANCER SCREENING

Published online by Cambridge University Press:  19 June 2013

Paula Cronin ,
Stephen Goodall ,
Trevor Lockett ,
Christine M. O'Keefe ,
Richard Norman  and
Jody Church
Paula Cronin
Affiliation:
Centre for Health Economics Research and Evaluation, Faculty of Business, University of Technology Sydney
Stephen Goodall
Affiliation:
Centre for Health Economics Research and Evaluation, Faculty of Business, University of Technology Sydney
Trevor Lockett
Affiliation:
Preventative Health National Research Flagship, CSIRO Food and Nutritional Science
Christine M. O'Keefe
Affiliation:
CSIRO Mathematics, Informatics and Statistics
Richard Norman
Affiliation:
Centre for Health Economics Research and Evaluation, Faculty of Business, University of Technology Sydney
Jody Church
Affiliation:
Centre for Health Economics Research and Evaluation, Faculty of Business, University of Technology Sydney
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Abstract

Objectives: The aim of this study is to evaluate the cost-effectiveness of a patient-direct mailed advance notification letter on participants of a National Bowel Cancer Screening Program (NBCSP) in Australia, which was launched in August 2006 and offers free fecal occult blood testing to all Australians turning 50, 55, or 65 years of age in any given year.

Methods: This study followed a hypothetical cohort of 50-year-old, 55-year-old, and 65-year-old patients undergoing fecal occult blood test (FOBT) screening through a decision analytic Markov model. The intervention compared two strategies: (i) advance letter, NBCSP, and FOBT compared with (ii) NBCSP and FOBT. The main outcome measures were life-years gained (LYG), quality-adjusted life-years (QALYs) gained and incremental cost-effectiveness ratio.

Results: An advance notification screening letter would yield an additional 54 per 100,000 colorectal cancer deaths avoided compared with no letter. The estimated cost-effectiveness was $3,976 per LYG and $6,976 per QALY gained.

Conclusions: An advance notification letter in the NBCSP may have a significant impact on LYG and cancer deaths avoided. It is cost-effective and offers a feasible strategy that could be rolled out across other screening program at an acceptable cost.

Keywords

Cost-effectiveness analysisScreeningColorectal cancer
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 29 , Issue 3 , July 2013 , pp. 261 - 268
Copyright
Copyright © Cambridge University Press 2013 

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