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Cost‐effectiveness of risk‐tailored screening strategy for colorectal cancer: A systematic review
Author(s) -
Wang Le,
Liu Chengcheng,
Wang Youqing,
Du Lingbin
Publication year - 2022
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15860
Subject(s) - medicine , cost effectiveness , systematic review , medline , cochrane library , quality adjusted life year , colorectal cancer , colorectal cancer screening , risk assessment , meta analysis , colonoscopy , risk analysis (engineering) , cancer , computer security , political science , computer science , law
Background and Aim Though one‐size‐fits‐all age‐based screening for colorectal cancer (CRC) is effective in reducing the incidence and mortality, the evidence regarding on personized screening based on individual risk factors has been growing. The study aimed to perform a systematic review to synthesize economic evidence of risk‐tailored CRC screening strategies. Methods This systematic review was conducted in EMBASE, Web of Science, PubMed, Cochrane Library, Econlit, and National Institute for Health Research Economic Evaluation Database from inception to June 30, 2021. We calculated the incremental cost‐effectiveness ratio (ICER) of cost per life year or quality‐adjusted life year gained for the risk‐tailored screening compared with no screening or uniform screening. A strategy was cost‐effective with less cost and equal or more effectiveness than the comparator along with lower ICER than the willingness‐to‐pay threshold. Results Our review finally comprised seven studies. Five studies reported the results of comparisons of risk‐tailored CRC screening with no screening, and supported that risk‐tailored screening was cost‐effective. All of seven studies reported the ICERs of risk‐tailored screening and age‐based screening. Disparities in the discrimination of risk‐prediction tool, accuracy of adopted techniques, uptake rate of screening and cost estimation impacted the cost‐effectiveness. Conclusions Studies on the economic evaluation of risk‐tailored CRC screening are limited, and current evidence is not sufficient to support the replacement of risk‐tailored screening for traditional age‐based screening.