J Prev Med Public Health.  2011 May;44(3):101-110. 10.3961/jpmph.2011.44.3.101.

Cost Effectiveness of Interventions to Promote Screening for Colorectal Cancer: A Randomized Trial

• Misra S
• Lairson DR
• Chan W
• Chang YC
• Bartholomew LK
• Greisinger A
• McQueen A
• Vernon SW

• KMID: 1093269
• DOI: http://doi.org/10.3961/jpmph.2011.44.3.101

Abstract

OBJECTIVES
Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention.
METHODS
A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping.
RESULTS
The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy.
CONCLUSIONS
The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and cost-effectiveness of interventions to increase colorectal cancer screening.

Keyword

Colorectal cancer; Cost-effectiveness; Screening promotion; Tailoring

MeSH Terms

Aged
Colorectal Neoplasms/*diagnosis
Cost-Benefit Analysis
Early Detection of Cancer/*economics/*methods
Female
Health Promotion/*methods
Humans
*Internet
Male
Middle Aged
Primary Health Care/organization & administration
United States