ArticleJournal of the National Cancer Institute2021
Comparing the Cost-Effectiveness of Innovative Colorectal Cancer Screening Tests.
Article in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 61 papers, 6 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
61 citing papers in PubMed, 6 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- The Role of Price Variation in Economic Analyses for Cancer Screenings: A Rapid Review.Applied health economics and health policy · 2026Pooled it
- Benefits of colorectal cancer screening using fecal immunochemical testing with varying positivity thresholds by age and sex.Journal of the National Cancer Institute · 2025Pooled 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
- Diagnostic accuracy of methylatedFrontiers in endocrinology · 2025Pooled it
- Health Economic Evidence and Modeling Challenges for Liquid Biopsy Assays in Cancer Management: A Systematic Literature Review.PharmacoEconomics · 2023Pooled it
- Diagnostic Accuracy of an Add-On, Blood-Based Screening Test for Colorectal Cancer in Two Established Screening Programmes.Alimentary pharmacology & therapeutics · 2025Trial
- Comparative effectiveness of two interventions to increase colorectal cancer screening among females living in the rural Midwest.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024Trial
- Cost-Effectiveness of Initiating Colorectal Cancer Screening at Age 40 Among Average-Risk Individuals in China.International journal of cancer · 2026Article
- Hypoxia Associated Integration of Epigenetic, Metabolic, and Immune Biomarkers in Blood and Urine for Early Colorectal Cancer Detection: A Multimarker Panel.Diagnostics (Basel, Switzerland) · 2026Article
- Protocol paper for an implementation science approach to promoting colorectal cancer screening in Federally Qualified Health Center Clinics: A stepped-wedge, multilevel intervention trial.Contemporary clinical trials · 2026Article
- Risk-based guidance for choosing fecal immunochemical test or colonoscopy in colorectal cancer screening: a modeling study.American journal of epidemiology · 2026Article
- The triple effect of colorectal cancer screening: reducing deaths, government spending, and mortality disparities.Journal of the National Cancer Institute · 2026Article
- 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
- Comparative benefits, burdens, and harms of emerging blood-based tests for colorectal cancer screening.Journal of the National Cancer Institute · 2026Article
- Cost-effectiveness of colon capsule endoscopy in colorectal cancer screening: a modeling study.Endoscopy · 2025Article
- Review
- 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
- Prognostic Significance of the Comprehensive Biomarker Analysis in Colorectal Cancer.Life (Basel, Switzerland) · 2025Review
- The Cost-Effectiveness of a Multi-Target Stool DNA-Based Screening (COLOTECT), FIT, Colonoscopy and No Screening for Colorectal Cancer.Cancer reports (Hoboken, N.J.) · 2025Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundColorectal cancer (CRC) screening with colonoscopy and the fecal immunochemical test (FIT) is underused. Innovative tests could increase screening acceptance. This study determined which of the available alternatives is most promising from a cost-effectiveness perspective.
methodsThe previously validated Microsimulation Screening Analysis-Colon model was used to evaluate the cost-effectiveness of screening with capsule endoscopy every 5 or 10 years, computed tomographic colonography every 5 years, the multi-target stool DNA test every 1 or 3 years, and the methylated SEPT9 DNA plasma assay (mSEPT9) every 1 or 2 years. We also compared these strategies with annual FIT screening and colonoscopy screening every 10 years. Quality-adjusted life-years gained (QALYG), number of colonoscopies, and incremental cost-effectiveness ratios were projected. We assumed a willingness-to-pay threshold of $100 000 per QALYG.
resultsAmong the alternative tests, computed tomographic colonography every 5 years, annual mSEPT9, and annual multi-target stool DNA screening had incremental cost-effectiveness ratios of $1092, $63 253, and $214 974 per QALYG, respectively. Other screening strategies were more costly and less effective than (a combination of) these 3. Under the assumption of perfect adherence, annual mSEPT9 screening resulted in more QALYG, CRC cases averted, and CRC deaths averted than annual FIT screening but led to a high rate of colonoscopy referral (51% after 3 years, 69% after 5 years). The alternative tests were not cost-effective compared with FIT and colonoscopy.
conclusionsThis study suggests that for individuals not willing to participate in FIT or colonoscopy screening, mSEPT9 is the test of choice if the high colonoscopy referral rate is acceptable to them.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.