, Volume 21, Issue 6, pp 596-601
Date: 12 Nov 2005

Cost–benefit analysis of screening colonoscopy in 40- to 50-year-old first-degree relatives of patients with colorectal cancer

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Abstract

Background and aims

As shown previously, 40- to 50-year-old first-degree relatives of patients with colorectal cancer (CRC) have significantly more colorectal adenomas than controls of the same age. Screening colonoscopy of these persons at risk between 40 and 50 years might be cost beneficial.

Methods

We prepared a detailed cost–benefit analysis of screening colonoscopy and possible repeat endoscopies according to current expenditures for endoscopic procedures in Germany. Since screening colonoscopy is generally offered and reimbursed from 55 years on in Germany, we analysed the period between 45 and 55 years, taking an annual interest rate of 5% into account. Costs were analysed based on the results of a former study [11] depending on various participation rates in a general screening programme.

Findings

Based on the available 1994 figure of about €20,000 for diagnosis and treatment of one cancer case, screening colonoscopy is cost beneficial when participation is high. Under a more realistic assumption of currently about €40,000 per cancer case, screening colonoscopy is cost beneficial in any case.

Interpretation

Our data support that systematic screening colonoscopy in first-degree relatives of patients with CRC by the age of 45 years most likely demonstrates an economic benefit.