ArticlePloS one2016
Cost Effectiveness of Screening Colonoscopy Depends on Adequate Bowel Preparation Rates - A Modeling Study.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 5 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Risk prediction models for inadequate bowel preparation before colonoscopy: A systematic review and meta-analysis.PloS one · 2026Pooled it
- Follow-up endoscopy rates as an indicator of effectiveness in colon capsule endoscopy: a systematic review and meta-analysis.BMJ open gastroenterology · 2025Pooled it
- Health Economic Evaluations of Circulating Tumor DNA Testing for Cancer Screening: Systematic Review.Cancer medicine · 2025Pooled it
- Pooled it
- Efficacy of ultra-low volume (≤1 L) bowel preparation fluids: Systematic review and meta-analysis.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2022Pooled it
- Impact of Milk Consumption the Day Before Colonoscopy on Bowel Preparation Quality: A Randomized Controlled Trial.Digestive diseases and sciences · 2026Trial
- Patient-directed vs. fixed-volume PEG for colonoscopy preparation: a randomized controlled trial.Precision clinical medicine · 2022Trial
- Comparative study between manitol and sodium picosulfate with magnesium oxide solutions in the preparation for colonoscopy.Revista do Colegio Brasileiro de Cirurgioes · 2022Trial
- Knowledge, attitudes, and practices toward bowel preparation for sedation-assisted colonoscopy among patients with digestive disorders: a structural equation modeling analysis.BMC gastroenterology · 2026Article
- Colonoscopy Quality and Strategies for Improvement.Gut and liver · 2026Review
- Is there a "weekend effect" in adenoma detection rate?A single-center retrospective study.PloS one · 2026Article
- Cost effectiveness analysis of three colorectal cancer screening modalities in Kuwait.Scientific reports · 2025Article
- Same-day yoga-based Laghu Shankhaprakshalana versus standard polyethylene glycol for rescue colonoscopy in inadequate bowel preparation-Feasibility and cost-effectiveness.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Article
- Establishment of a risk prediction model for bowel preparation failure prior to colonoscopy.BMC cancer · 2024Article
- Screening Implications for Distribution of Colorectal Cancer Subsite by Age and Role of Flexible Sigmoidoscopy.Cancers · 2024Article
- Boston bowel preparation scale score 6 has more missed lesions compared with 7-9.Scientific reports · 2024Article
- Efficacy of different bowel preparation regimen volumes for colorectal cancer screening and compliance with European Society of Gastrointestinal Endoscopy performance measures.United European gastroenterology journal · 2023Article
- Article
- Efficacy and tolerability of high and low-volume bowel preparation compared: A real-life single-blinded large-population study.World journal of gastrointestinal endoscopy · 2021Article
- Colonoscopy in poorly prepped colons: a cost effectiveness analysis comparing standard of care to a new cleansing technology.Cost effectiveness and resource allocation : C/E · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInadequate bowel preparation during screening colonoscopy necessitates repeating colonoscopy. Studies suggest inadequate bowel preparation rates of 20-60%. This increases the cost of colonoscopy for our society.
aimThe aim of this study is to determine the impact of inadequate bowel preparation rate on the cost effectiveness of colonoscopy compared to other screening strategies for colorectal cancer (CRC).
methodsA microsimulation model of CRC screening strategies for the general population at average risk for CRC. The strategies include fecal immunochemistry test (FIT) every year, colonoscopy every ten years, sigmoidoscopy every five years, or stool DNA test every 3 years. The screening could be performed at private practice offices, outpatient hospitals, and ambulatory surgical centers.
resultsAt the current assumed inadequate bowel preparation rate of 25%, the cost of colonoscopy as a screening strategy is above society's willingness to pay (<$50,000/QALY). Threshold analysis demonstrated that an inadequate bowel preparation rate of 13% or less is necessary before colonoscopy is considered more cost effective than FIT. At inadequate bowel preparation rates of 25%, colonoscopy is still more cost effective compared to sigmoidoscopy and stool DNA test. Sensitivity analysis of all inputs adjusted by ±10% showed incremental cost effectiveness ratio values were influenced most by the specificity, adherence, and sensitivity of FIT and colonoscopy.
conclusionsScreening colonoscopy is not a cost effective strategy when compared with fecal immunochemical test, as long as the inadequate bowel preparation rate is greater than 13%.
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