ArticleAnnals of internal medicine2024
Projected Impact and Cost-Effectiveness of Novel Molecular Blood-Based or Stool-Based Screening Tests for Colorectal Cancer.
Article in Annals of internal medicine, 2024. 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 13 papers.
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
13 citing papers in PubMed.
- Bridging the Precancerous Gap in Colorectal Cancer Through AI-Enhanced Liquid Biopsy, Endoscopy, and Digital Pathology.Cancers · 2026Review
- Long-term effectiveness of a two-step colorectal cancer screening strategy and risk of colorectal cancer after polypectomy.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2026Article
- The Centers for Medicare and Medicaid Services and others misunderstand stool testing for colorectal cancer.Journal of the National Cancer Institute · 2026Review
- Novel Liquid Biopsy in Gastrointestinal Cancers.Journal of gastroenterology and hepatology · 2026Review
- Comparative benefits, burdens, and harms of emerging blood-based tests for colorectal cancer screening.Journal of the National Cancer Institute · 2026Article
- FIT and molecular tests versus colonoscopy: an economic evaluation of colorectal cancer screening in the United States.Frontiers in oncology · 2026Article
- RE: Evaluating benefit-to-burden ratios of the established and emerging colorectal cancer screening strategies.Journal of the National Cancer Institute · 2025Article
- Evaluating benefit-to-burden ratios of the established and emerging colorectal cancer screening strategies.Journal of the National Cancer Institute · 2025Article
- The impact of adherence on colorectal cancer screening cost-effectiveness: A modeling study.PLoS medicine · 2025Article
- Novel colorectal cancer screening methods - opportunities and challenges.Nature reviews. Clinical oncology · 2025Review
- Beyond the Scope: The Promise and Limitations of Blood-Based Colorectal Cancer Screening.Gastroenterology & hepatology · 2025Article
- A Blood-Based Test for Colorectal Cancer Screening.HCA healthcare journal of medicine · 2025Article
- New Compass for Precision Oncology: Evidence, Challenges, and Prospects of Circulating Tumor DNA in Colorectal Cancer.Cancer control : journal of the Moffitt Cancer CenterReview
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
Abstract
backgroundCell-free DNA blood tests (cf-bDNA) and next-generation stool tests could change colorectal cancer (CRC) screening.
objectiveTo estimate the clinical and economic impacts of novel CRC screening tests.
designCost-effectiveness analysis using MOSAIC (Model of Screening and Surveillance for Colorectal Cancer). DATA SOURCES: Published data. TARGET POPULATION: Average-risk persons. TIME HORIZON: Ages 45 to 100 years. PERSPECTIVE: Health sector.
interventionNovel versus established CRC screening tests. OUTCOME MEASURES: Incidence and mortality of CRC, quality-adjusted life-years (QALYs), costs. RESULTS OF BASE-CASE ANALYSIS: For colonoscopy every 10 years, annual fecal immunochemical test (FIT), and triennial next-generation multitarget stool DNA, FIT-RNA, cf-bDNA (Guardant Shield), or cf-bDNA (Freenome), the relative rates (RRs) and 95% uncertainty intervals (UIs) versus no screening for CRC incidence were 0.21 (0.19 to 0.22), 0.29 (0.27 to 0.31), 0.33 (0.32 to 0.36), 0.32 (0.30 to 0.34), 0.58 (0.55 to 0.61) and 0.58 (0.55 to 0.60), respectively; the RRs for CRC death were 0.19 (0.17 to 0.20), 0.25 (0.23 to 0.27), 0.28 (0.27 to 0.30), 0.28 (0.26 to 0.30), 0.44 (0.42 to 0.47), and 0.46 (0.44 to 0.49), respectively. The cf-bDNA test (Shield; list price $1495) cost $89 600 ($74 800 to $102 300) per QALY gained versus no screening; alternatives were less costly and more effective. RESULTS OF SENSITIVITY ANALYSIS: Incremental costs exceeded incremental benefits when novel test intervals were shortened to 2 or 1 years. The cf-bDNA test matched FIT's impact on CRC mortality at 1.35 (1.30 to 1.40)-fold FIT's uptake rate, assuming equal colonoscopy follow-up. If persons who accept colonoscopy or stool tests shifted to cf-bDNA, CRC deaths increased. This adverse effect was overcome if every 3 such substitutions were counterbalanced by cf-bDNA uptake by 2 or more persons refusing alternatives, assuming equal colonoscopy follow-up. LIMITATION: Longitudinal test-specific participation patterns are unknown.
conclusionFirst-generation cf-bDNA tests may deliver net benefit or harm, depending on the balance between achieving screening in persons who decline alternatives versus substituting cf-bDNA for more effective alternatives. PRIMARY FUNDING SOURCE: The Gorrindo Family Fund.
Indexed as
Identifiers
What OpenQuestion holds
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.