Evidence map›Paper›PMID 38552671›Full record

ArticleGastroenterology2024

Effectiveness and Cost-Effectiveness of Colorectal Cancer Screening With a Blood Test That Meets the Centers for Medicare & Medicaid Services Coverage Decision.

Rosita van den Puttelaar, Pedro Nascimento de Lima, Amy B Knudsen, Carolyn M Rutter, Karen M Kuntz, Lucie de Jonge, Fernando Alarid Escudero, David Lieberman, Ann G Zauber, Anne I Hahn and 2 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 2 pooled it
15.0field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 9 institutions in 2 countries.

Rosita van den PuttelaarDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands. Electronic address: r.vandenputtelaar@erasmusmc.nl.
Pedro Nascimento de LimaRAND Corporation, Arlington, Virginia.
Amy B KnudsenInstitute for Technology Assessment, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
Carolyn M RutterFred Hutchinson Cancer Research Center, Hutchinson Institute for Cancer Outcomes Research & Biostatistics Program, Public Health Sciences Division, Seattle, Washington.
Karen M KuntzDivision of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota.
Lucie de JongeDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Fernando Alarid EscuderoDepartment of Health Policy, School of Medicine, and Stanford Health Policy, Freeman-Spogli Institute for International Studies, Stanford University, Stanford, California.
David LiebermanDivision of Gastroenterology, Department of Medicine, Oregon Health and Science University, Portland, Oregon.
Ann G ZauberDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
Anne I HahnDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
John M InadomiDepartment of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
Iris Lansdorp-VogelaarDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Erasmus MC · NLMemorial Sloan Kettering Cancer Center · USFred Hutch Cancer Center · USMassachusetts General Hospital · USOregon Health & Science University · USRAND Corporation · USStanford University · USUniversity of Minnesota · USUniversity of Utah · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
Comparative Modeling of Effective Policies for Colorectal Cancer ControlU01CA253913 · NCI · SLOAN-KETTERING INST CAN RESEARCH · PI RUTTER, CAROLYN M, ZAUBER, ANN GRAHAM · 2020 to 2025
$6.5M
NCI NIH HHS P30 CA008748NCI NIH HHS U01 CA253913
6 · The paper itself

Abstract

BACKGROUND &

aimsA blood-based colorectal cancer (CRC) screening test may increase screening participation. However, blood tests may be less effective than current guideline-endorsed options. The Centers for Medicare & Medicaid Services (CMS) covers blood tests with sensitivity of at least 74% for detection of CRC and specificity of at least 90%. In this study, we investigate whether a blood test that meets these criteria is cost-effective.

methodsThree microsimulation models for CRC (MISCAN-Colon, CRC-SPIN, and SimCRC) were used to estimate the effectiveness and cost-effectiveness of triennial blood-based screening (from ages 45 to 75 years) compared to no screening, annual fecal immunochemical testing (FIT), triennial stool DNA testing combined with an FIT assay, and colonoscopy screening every 10 years. The CMS coverage criteria were used as performance characteristics of the hypothetical blood test. We varied screening ages, test performance characteristics, and screening uptake in a sensitivity analysis.

resultsWithout screening, the models predicted 77-88 CRC cases and 32-36 CRC deaths per 1000 individuals, costing $5.3-$5.8 million. Compared to no screening, blood-based screening was cost-effective, with an additional cost of $25,600-$43,700 per quality-adjusted life-year gained (QALYG). However, compared to FIT, triennial stool DNA testing combined with FIT, and colonoscopy, blood-based screening was not cost-effective, with both a decrease in QALYG and an increase in costs. FIT remained more effective (+5-24 QALYG) and less costly (-$3.2 to -$3.5 million) than blood-based screening even when uptake of blood-based screening was 20 percentage points higher than uptake of FIT.

conclusionEven with higher screening uptake, triennial blood-based screening, with the CMS-specified minimum performance sensitivity of 74% and specificity of 90%, was not projected to be cost-effective compared with established strategies for colorectal cancer screening.

Indexed as

ColonoscopyColorectal NeoplasmsCost-Benefit AnalysisEarly Detection of CancerOccult BloodAgedCenters for Medicare and Medicaid Services, U.S.Computer SimulationFecesFemaleHumansMaleMiddle AgedModels, EconomicPredictive Value of TestsQuality-Adjusted Life YearsBiomarkersColorectal CancerCost-Effectiveness

Identifiers

PMID38552671
PMCPMC11193618
OpenAlexW4393194967

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.