• Pol. Arch. Med. Wewn. · Feb 2021

    Cost-effectiveness of colonoscopy in the organized screening program.

    • Bartlomiej Krzeczewski, Cesare Hassan, Olga Krzeczewska, Paulina Wieszczy, Malgorzata Pisera, Anna Ciopinska-Chaber, Maciej Rupinski, Andrzej Sliwczynski, Radoslaw Pastusiak, Jaroslaw Regula, and Michal F Kaminski.
    • Department of Corporate Finance, Faculty of Economics and Sociology, University of Lodz, Łódź, Poland. bartlomiej.krzeczewski@uni.lodz.pl
    • Pol. Arch. Med. Wewn. 2021 Feb 26; 131 (2): 128-135.

    IntroductionColorectal cancer (CRC) is a serious health problem, and various screening programs to reduce CRC have been introduced worldwide. However, the cost‑effectiveness of a program based on once‑in‑a‑lifetime colonoscopy in Poland is unknown.ObjectivesThe main aim of this study was to assess the cost‑effectiveness of Polish Colonoscopy Screening Platform (PCSP), the colonoscopy screening program in Poland.Patients And MethodsA Markov model was constructed to compare the strategy of colonoscopy screening as compared with no screening in 100 000 subjects. The model was based on data collected from the nationwide Polish CRC screening program whenever possible. The incremental cost‑effectiveness ratio (ICER) was calculated and compared with the willingness‑to‑pay thresholds. A sensitivity analysis was also performed using the Monte Carlo simulation.ResultsColonoscopy screening within PCSP resulted in a 18.9% reduction in CRC incidence and 19.8% reduction in CRC mortality. The strategy allowed a gain of 2317 life‑years saved (1959 after discount‑ ing). The cost of colonoscopy screening per participant examined was estimated at 267.70 USD (95% CI, 263.08-272.32 USD). The ICER was less than 6500 USD, which was much lower than the accepted willingness‑to‑pay thresholds, indicating that the screening was cost‑effective.ConclusionsColonoscopy screening within the PCSP is cost‑effective and may have a substantial impact on the Polish society due to life‑years saved. The results have good informative value not only for health policy makers and medical practitioners, but also for health technology assessment.

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