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Comparative Effectiveness and Cost-Effectiveness of Current CRC Screening Modalities

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Colorectal Cancer Screening

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Abstract

Colorectal cancer (CRC) screening has been credited with more than a 50 % reduction in CRC mortality over the past 30 years. We now have multiple CRC screening tests. In this chapter, we discuss how to compare different CRC screening tests with respect to effectiveness, comparative effectiveness, and cost-effectiveness. Donabedian initiated the issue of quality of health care in 1992 to include the issues of effectiveness, optimality in balancing resources against health-care gains, and the acceptability to the patient of performing different screening tests. The multisociety CRC screening guidelines of 1997 included the blueprint for how to compare different CRC screening tests and how to include new CRC screening tests in recommendations to those already established. This chapter provides examples of these comparisons and is meant to be a guide to a clinician as to pertinent aspects of comparative effectiveness and cost-effectiveness analyses. Examples in this chapter discuss how comparative effectiveness and cost-effectiveness analyses are informative in addressing the clinical question of the balance in risk and benefits, and with regard to the age to stop screening depending on to the comorbidities of their patients. Given the large impact that CRC screening can have to reduce CRC mortality, it is imperative that we continue to assess what are the CRC screening options and strategies that can provide the greatest impact for the population and most efficiently use our medical resources.

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Acknowledgments

This work is supported in part from the following grants: U01 CA-152959, U01 CA-151736, U54 CA-163262, and R01 CA-079572.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 307 East 63 Street, Room 357, 10065, New York, NY, USA

    Ann G. Zauber

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  1. Ann G. Zauber
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Correspondence to Ann G. Zauber .

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Editors and Affiliations

  1. Department of Gastroenterology, Minneapolis VA Medical Center, Minneapolis, Minnesota, USA

    Aasma Shaukat

  2. Department of Medicine, Yale University, New Haven, Connecticut, USA

    John I. Allen

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Zauber, A. (2015). Comparative Effectiveness and Cost-Effectiveness of Current CRC Screening Modalities. In: Shaukat, A., Allen, J. (eds) Colorectal Cancer Screening. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2333-5_3

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  • DOI: https://doi.org/10.1007/978-1-4939-2333-5_3

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