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Approche médico-économique du dépistage du cancer colorectal

  • C. Lejeune
Chapter
Part of the Dépistage et cancer book series (DC)

Conclusion

Peu d’analyses médico-économiques du dépistage du cancer colorectal dans la population générale ont été entreprises en Europe. La preuve de l’efficacité et de l’intérêt médico-économique du test Hemoccult II® a été apportée par deux études randomisées européennes et une étude contrôlée française. Les tests immunologiques représentent une alternative à ce test, mais les résultats des études cherchant à en démontrer l’efficience sont discordants. Quant au coloscanner et au dépistage génétique, ils n’ont pas encore été évalués en Europe sur le plan médico-économique, faute de données disponibles. La littérature scientifique anglosaxonne est riche d’analyses coût-efficacité du dépistage du cancer colorectal. Mais les hypothèses sur lesquelles reposent les modèles peuvent être discutées. Par ailleurs, les modèles construits diffèrent souvent par les coûts du fait de modes de valorisation sensiblement différents, mais surtout par la nature des hypothèses épidémiologiques utilisées comme l’histoire naturelle de la maladie, les performances diagnostiques des tests et les taux de participation aux campagnes de dépistage.

Ces méthodes pourraient être utilisées uniquement dans des groupes spécifiques à risque de cancer colorectal pour lesquelles il n’existe encore aucune recommandation de dépistage (et notamment chez les parents au premier degré de sujets atteints d’un cancer colorectal après l’âge de 60 ans).

Pour conclure, il apparaît important de développer de nouveaux axes de recherche afin d’apporter des éléments de réponse pertinents et des outils d’aide à la décision sur le plan médico-économique, tant en population générale que dans les groupes à risque élevé de cancer colorectal.

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Copyright information

© Springer-Verlag France, Paris 2006

Authors and Affiliations

  • C. Lejeune
    • 1
  1. 1.Faculté de médecineRegistre bourguignon des cancers digestifs (INSERM EMI 0106)Dijon CedexFrance

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