ArticlePloS one2019
Cost-effectiveness of a multitarget stool DNA test for colorectal cancer screening of Medicare beneficiaries.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
30 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Colorectal cancer screening methods: A systematic review.Medicine · 2025Pooled it
- The role of health economic evidence in clinical practice guidelines for colorectal cancer: a comparative analysis across countries.Journal of comparative effectiveness research · 2025Pooled it
- Health Economic Evaluations of Circulating Tumor DNA Testing for Cancer Screening: Systematic Review.Cancer medicine · 2025Pooled it
- Pooled it
- Cost-Effectiveness of Initiating Colorectal Cancer Screening at Age 40 Among Average-Risk Individuals in China.International journal of cancer · 2026Article
- Diagnostic Potential of Exosomes in Colorectal Cancer: Current Advances and Future Perspectives.Molecules (Basel, Switzerland) · 2026Review
- Benefits, Harms, and Burden of Colorectal Cancer Screening Among Childhood Cancer Survivors Previously Treated With Abdominopelvic Radiation.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026Article
- Adherence to Follow-Up Colonoscopy After a Positive Stool-Based Test in Patients Aged 45-49 Years: Real-World Differences Between Multitarget Stool DNA Testing and Fecal Immunochemical or Fecal Occult Blood Testing.Gastro hep advances · 2025Article
- Utilization of molecular genetic approaches for colorectal cancer screening.World journal of gastroenterology · 2024Article
- Impact of the serrated pathway on the simulated comparative effectiveness of colorectal cancer screening tests.JNCI cancer spectrum · 2024Article
- Review
- Colorectal cancer screening: A review of current knowledge and progress in research.World journal of gastrointestinal oncology · 2024Review
- Network approach in liquidomics landscape.Journal of experimental & clinical cancer research : CR · 2023Review
- Colon Cancer Screening Methods: 2023 Update.Cureus · 2023Review
- Review
- Potential prognostic and predictive value of UBE2N, IMPDH1, DYNC1LI1 and HRASLS2 in colorectal cancer stool specimens.Biomedical reports · 2023Article
- Endoscopists' recommendations after a false positive multitarget stool DNA test: results from a multicenter study.iGIE : innovation, investigation and insights · 2023Article
- Cost-Effectiveness of Colorectal Cancer Surveillance in Hodgkin Lymphoma Survivors Treated with Procarbazine and/or Infradiaphragmatic Radiotherapy.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Article
- Cost-Effectiveness of Waiving Coinsurance for Follow-Up Colonoscopy after a Positive Stool-Based Colorectal Screening Test in a Medicare Population.Cancer prevention research (Philadelphia, Pa.) · 2022Article
- Circulating tumour DNA - looking beyond the blood.Nature reviews. Clinical oncology · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundIn 2014, the Centers for Medicare and Medicaid Services (CMS) began covering a multitarget stool DNA (mtSDNA) test for colorectal cancer (CRC) screening of Medicare beneficiaries. In this study, we evaluated whether mtSDNA testing is a cost-effective alternative to other CRC screening strategies reimbursed by CMS, and if not, under what conditions it could be.
methodsWe use three independently-developed microsimulation models to simulate a cohort of previously unscreened US 65-year-olds who are screened with triennial mtSDNA testing, or one of six other reimbursed screening strategies. Main outcome measures are discounted life-years gained (LYG) and lifetime costs (CMS perspective), threshold reimbursement rates, and threshold adherence rates. Outcomes are expressed as the median and range across models.
resultsCompared to no screening, triennial mtSDNA screening resulted in 82 (range: 79-88) LYG per 1,000 simulated individuals. This was more than for five-yearly sigmoidoscopy (80 (range: 71-89) LYG), but fewer than for every other simulated strategy. At its 2017 reimbursement rate of $512, mtSDNA was the most costly strategy, and even if adherence were 30% higher than with other strategies, it would not be a cost-effective alternative. At a substantially reduced reimbursement rate ($6-18), two models found that triennial mtSDNA testing was an efficient and potentially cost-effective screening option.
conclusionsCompared to no screening, triennial mtSDNA screening reduces CRC incidence and mortality at acceptable costs. However, compared to nearly all other CRC screening strategies reimbursed by CMS it is less effective and considerably more costly, making it an inefficient screening option.
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