Evidence map›Paper›PMID 40439982›Full record

ArticleCancer causes & control : CCC2025

Estimating the long-term health impact and program cost-effectiveness of providing direct screening services to low-income, medically underserved patients through the Colorectal Cancer Control Program (CRCCP).

Meghan C O'Leary, Priscille R Koutouan, Maria E Mayorga, Krishna P Sharma, Amy DeGroff, Lisa C Richardson, Kristen Hassmiller Lich

Abstract read
In one paragraph

Article in Cancer causes & control : CCC, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

7 authors.

Meghan C O'LearyDepartment of Health Policy & Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. mcoleary@live.unc.edu.
Priscille R KoutouanDepartment of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, USA.
Maria E MayorgaDepartment of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, USA.
Krishna P SharmaCenters for Disease Control and Prevention, Atlanta, GA, USA.
Amy DeGroffCenters for Disease Control and Prevention, Atlanta, GA, USA.
Lisa C RichardsonCenters for Disease Control and Prevention, Atlanta, GA, USA.
Kristen Hassmiller LichDepartment of Health Policy & Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Funding

Cancer Care Quality Training ProgramT32CA116339 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ETHAN M. BASCH, Stephanie Brooke Wheeler · 2018 to 2026
$3.0M
Intramural CDC HHS CC999999National Association of Chronic Disease Directors 5-NU38OT000286NCI NIH HHS T32 CA116339NIH HHS T32-CA-116339OSTLTS CDC HHS NU38OT000286
6 · The paper itself

Abstract

purposeThe Colorectal Cancer Control Program (CRCCP) aimed to increase colorectal cancer (CRC) screening among U.S. medically underserved populations through promotion and provision of CRC screening. We used simulation modeling to estimate the lifelong health impact and program cost-effectiveness of direct screening services, typically a single cycle of routine screening/follow-up testing provided through the CRCCP ("intervention").

methodsData for this study were from CDC's Colorectal Clinical Data Elements (CCDE), which captured screening and follow-up services received from CRCCP between 2009 and 2020. We used microsimulation to model the evolution of polyps and CRC for average-risk individuals in intervention and "counterfactual" (control) groups, under multiple scenarios. We calculated and compared lifetime CRC outcomes (cases, deaths, life-years) for individuals with and without the CRCCP intervention. Clinical and implementation costs incurred by the CRCCP were used to estimate programmatic/intervention costs. Results are reported overall and by initial screening modality received (colonoscopy or stool testing) and assumed lower vs. higher "background" (non-intervention) screening scenarios.

resultsWith conservative assumptions, our findings suggest that CRCCP-provided screening averted 806 CRC cases, avoided 392 CRC deaths, and added 5,368 life-years per 100,000 individuals vs. no intervention. Cost-effectiveness analysis revealed that the program's cost per life-year gained varied by screening modality and scenario assumptions-ranging from $25,740 to $27,583 for colonoscopy screening and $70,410 to $75,979 for stool testing.

conclusionCRCCP-provided screening/testing services were found to produce substantial potential health gains. Our analysis estimates the cost-effectiveness of providing one cycle of screening/testing to medically underserved individuals to inform programmatic decisions.

Indexed as

Colorectal NeoplasmsEarly Detection of CancerMass ScreeningPovertyAgedColonoscopyCost-Benefit AnalysisFemaleHumansMaleMedically Underserved AreaMiddle AgedUnited StatesColorectal cancer screeningEconomic evaluationMedically underserved populationsSimulation

Identifiers

PMID40439982
PMCPMC12320612

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.