ArticleBMC gastroenterology2019
Effectiveness, benefit harm and cost effectiveness of colorectal cancer screening in Austria.
Article in BMC gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis 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.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Screening for colorectal cancer : A recommendation statement of the Austrian National Committee for Cancer Screening.Wiener klinische Wochenschrift · 2023Guideline
- The efficacy of colorectal cancer screening: a systematic review and meta-analysis.Preventive medicine reports · 2026Review
- Protocol for the health economic evaluation of nature-based social prescribing against loneliness alongside the RECETAS trials.BMC public health · 2026Article
- Metabolic syndrome and risk of advanced colorectal adenomas in a screening population: Frequentist and Bayesian analyses.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Article
- Individual Preference for Fecal Immunochemical Test Options among Younger Adults: A Discrete Choice Experiment.PharmacoEconomics - open · 2026Article
- The Cost-Effectiveness of Organized National Colorectal Cancer Screening Program in Croatia.Cancers · 2025Article
- A Scoping Review on Calibration Methods for Cancer Simulation Models.Medical decision making : an international journal of the Society for Medical Decision Making · 2025Article
- Insights from age-stratified endoscopic detection metrics support initiating colorectal cancer screening at age 45.BMC gastroenterology · 2025Article
- Can Salivary Biomarkers Serve as Diagnostic and Prognostic Tools for Early Detection in Patients with Colorectal Cancer? A Systematic Review.Current issues in molecular biology · 2025Review
- Shall We Screen Lung Cancer with Volume Computed Tomography in Austria? A Cost-Effectiveness Modelling Study.Cancers · 2024Article
- Overcoming geographical and socioeconomic limitations in colorectal cancer screening.World journal of gastrointestinal oncology · 2024Article
- Bowel Preparation Burden, Rectal Pain and Abdominal Discomfort: Perspective of Participants Undergoing CT Colonography and Colonoscopy.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Colorectal Cancer (CRC) Screening Literacy and Facilitators Related to a Free Screening Program in Thailand.Asian Pacific journal of cancer prevention : APJCP · 2023Article
- Feasibility of Continuous Monitoring of Endoscopy Performance and Adverse Events: A Single-Center Experience.Cancers · 2023Article
- Colorectal cancer screening in Semarang, Indonesia: A multicenter primary health care based study.PloS one · 2023Article
- Colorectal Cancer in Younger Adults.Hematology/oncology clinics of North America · 2022Review
- The role of artificial intelligence based systems for cost optimization in colorectal cancer prevention programs.Frontiers in artificial intelligence · 2022Review
- Cost-Effectiveness of Colorectal Cancer Genetic Testing.International journal of environmental research and public health · 2021Article
- Extending Age Ranges in Breast Cancer Screening in Four European Countries: Model Estimations of Harm-to-Benefit Ratios.Cancers · 2021Article
- Article
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClear evidence on the benefit-harm balance and cost effectiveness of population-based screening for colorectal cancer (CRC) is missing. We aim to systematically evaluate the long-term effectiveness, harms and cost effectiveness of different organized CRC screening strategies in Austria.
methodsA decision-analytic cohort simulation model for colorectal adenoma and cancer with a lifelong time horizon was developed, calibrated to the Austrian epidemiological setting and validated against observed data. We compared four strategies: 1) No Screening, 2) FIT: annual immunochemical fecal occult blood test age 40-75 years, 3) gFOBT: annual guaiac-based fecal occult blood test age 40-75 years, and 4) COL: 10-yearly colonoscopy age 50-70 years. Predicted outcomes included: benefits expressed as life-years gained [LYG], CRC-related deaths avoided and CRC cases avoided; harms as additional complications due to colonoscopy (physical harm) and positive test results (psychological harm); and lifetime costs. Tradeoffs were expressed as incremental harm-benefit ratios (IHBR, incremental positive test results per LYG) and incremental cost-effectiveness ratios [ICER]. The perspective of the Austrian public health care system was adopted. Comprehensive sensitivity analyses were performed to assess uncertainty.
resultsThe most effective strategies were FIT and COL. gFOBT was less effective and more costly than FIT. Moving from COL to FIT results in an incremental unintended psychological harm of 16 additional positive test results to gain one life-year. COL was cost saving compared to No Screening. Moving from COL to FIT has an ICER of 15,000 EUR per LYG.
conclusionsOrganized CRC-screening with annual FIT or 10-yearly colonoscopy is most effective. The choice between these two options depends on the individual preferences and benefit-harm tradeoffs of screening candidates.
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Registered trials
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