Abstract
PURPOSE: This study was performed to assess, from the aspects of screening efficiency and cost-effectiveness, the optimal lower limit of age in immunochemical occult blood screening for colorectal cancer. METHODS: Seven thousand four hundred asymptomatic individuals were the subjects of this study. They gave samples for an immunochemical fecal occult blood test (OC-Hemodia®), and colonoscopy was performed during a medical checkup. They were divided into three groups according to their ages: younger (40–49), middle (50–59), and older (60+) groups. The detection rate for colorectal cancer and the average costs to detect one patient with colorectal cancer were evaluated among the three groups. RESULTS: The detection rate for colorectal cancer and the average costs to detect one cancer patient were calculated as 0.3 percent and $6024 for the younger group, 1.6 percent and $1425 for the middle group, and 1.7 percent and $1410 for the older group, respectively. The cancer detection rate was significantly different between the younger and middle groups (P<0.05) and between the younger and older groups (P<0.05). CONCLUSIONS: This analysis suggests that the subjects aged less than 50 have some disadvantage when carrying out the immunochemical fecal occult blood test, OC-Hemodia® for colorectal cancer screening, from the aspects of screening efficiency and cost-effectiveness.
Similar content being viewed by others
References
Mandel JS, Bond JH, Church TR,et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. N Engl J Med 1993;328:1365–71.
Kronborg O, Fenger C, Olsen J, Jorgensen OD, Sondergaard O. Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet 1996;348:1467–71.
Hardcastle JD, Chamberlain JO, Robinson MH,et al. Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet 1996;348:1472–7.
Nakama H, Kamijo N. Accuracy of the immunological fecal occult blood testing for colorectal cancer screening. Prev Med 1994;23:309–13.
Nakama H, Kamijo N, Fattah AS, Zhang B. Validity of immunological faecal occult blood screening for colorectal cancer screening: a follow up study. J Med Screen 1996;3:63–5.
Itoh M, Takahashi K, Nishida H, Sakagami K, Okubo T. Estimation of the optimal cut off point in a new immunological faecal occult test in a corporate colorectal cancer screening programme. J Med Screen 1966;3:66–71.
Allison JE, Tekawa IS, Ranson LJ,et al. A comparison of fecal occult-blood tests for colorectal-cancer screening. N Engl J Med 1996;334:155–9.
Simon JB. Occult blood screening for colorectal cancer: a critical review. Gastroenterology 1985;88:820–37.
Rogge JD, Elmore MF, Mahoney SJ,et al. Low-cost, office-based, screening colonoscopy. Am J Gastroenterol 1994;89:1775–80.
Lieberman DA. Cost-effectiveness model for colon cancer screening. Gastroenterology 1995;109:1781–90.
Provenzale D, Lipscomb J. A reader's guide to economic analaysis in the GI literature. Am J Gastroenterol 1996;91:2461–70.
Saito H. Screening for colorectal cancer by immunochemical fecal occult blood test. Jpn J Cancer Res 1996;87:1011–24.
Saito H, Yoshida Y. Mass screening—Japanese perspective. In: Young GP, Rosen P, Levine B, eds. Prevention and early detection of colorectal cancer: principles and practice. London: WB Saunders, 1996:301–11.
Tsuji I, Fukao A, Shoji T, Kuwajima I, Sugawara N, Hisamichi S. Cost-effectiveness analysis of screening for colorectal cancer in Japan. Tohoku J Exp Med 1991;164:269–378.
Shimbo T, Glick HA, Eisenberg JM. Cost-effectiveness analysis of strategies for colorectal cancer screening in Japan. Int J Technol Assess Health Care 1994;10:359–75.
Author information
Authors and Affiliations
Additional information
Supported in part by Grants-in-Aid for Scientific Research (No. 09670384) from the Ministry of Education, Science and Culture of Japan and Cancer Research (No. 8-2) from the Ministry of Health and Welfare of Japan.
About this article
Cite this article
Nakama, H., Zhang, B., Zhang, X. et al. Age-related cancer detection rate and costs for one cancer detected in one screening by immunochemical fecal occult blood test. Dis Colon Rectum 44, 1696–1699 (2001). https://doi.org/10.1007/BF02234392
Issue Date:
DOI: https://doi.org/10.1007/BF02234392