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Cost-Effectiveness Analysis of a Colonoscopy Screening Navigator Program Designed for Hispanic Men

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Abstract

Although Hispanic men are at higher risk of developing colon cancer compared to non-Hispanic white men, colonoscopy screening among Hispanic men is much lower than among non-Hispanic white men. University Health System (UHS) in San Antonio, Texas, instituted a Colorectal Cancer Male Navigation (CCMN) Program in 2011 specifically designed for Hispanic men. The CCMN Program contacted 461 Hispanic men 50 years of age and older to participate over a 2-year period. Of these age-eligible men, 370 were screened for CRC after being contacted by the navigator. Using participant and program data, a Markov model was constructed to determine the cost-effectiveness of the CCMN Program. An average 50-year-old Hispanic male who participates in the CCMN Program will have 0.3 more quality-adjusted life-years (QALYs) compared to a similar male receiving usual care. Life expectancy is also predicted to increase by 6 months for participants compared to non-participants. The program results in net health care savings of $1,148 per participant ($424,760 for the 370 CCMN Program participants). The incremental cost-effectiveness ratio is estimated at $3,765 per QALY in favor of the navigation program. Interventions to reduce disparities in CRC screening across ethnic groups are needed, and this is one of the first studies to evaluate the economic benefit of a patient navigator program specifically designed for an urban population of Hispanic men. A colorectal cancer screening intervention which relies on patient navigators trained to address the unique needs of the targeted population (language barriers, transportation and scheduling assistance, colon cancer, and screening knowledge) can substantially increase the likelihood of screening and improve quality of life in a cost-effective manner.

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Conflict of Interest

The authors do not have any financial disclosures or conflicts of interest.

Funding Support

This study was funded by the Cancer Prevention and Research Institute of Texas (award grant ID PP110120).

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Authors and Affiliations

  1. Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, 68198, NE, USA

    Fernando A. Wilson & Jim P. Stimpson

  2. University Health System, 527 N. Leona Street, San Antonio, 78207, TX, USA

    Roberto Villarreal

  3. Center for Health Innovation, The New York Academy of Medicine, 1216 Fifth Avenue, New York, NY, 10029, USA

    José A. Pagán

  4. Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk, Philadelphia, 19104, PA, USA

    José A. Pagán

Authors
  1. Fernando A. Wilson
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  2. Roberto Villarreal
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  3. Jim P. Stimpson
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  4. José A. Pagán
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Correspondence to José A. Pagán.

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Wilson, F.A., Villarreal, R., Stimpson, J.P. et al. Cost-Effectiveness Analysis of a Colonoscopy Screening Navigator Program Designed for Hispanic Men. J Canc Educ 30, 260–267 (2015). https://doi.org/10.1007/s13187-014-0718-7

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  • DOI: https://doi.org/10.1007/s13187-014-0718-7

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