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Virtual Colonoscopy is Most-effective for Screening Colon Cancer

his model of 100,000 persons over 50 years old, CTC with OC follow-up of polyps greater than 5 mm was the most cost-effective screening test. According to cost per life-year gained calculations, CTC with a 6-mm threshold for follow-up cost only $4,361 while OC cost $9,180 per life-year gained. CTC with no polyp size threshold cost $7,138, and FS cost $7,407 per life-year gained.

The incremental costs of working-up lesions smaller than 6 mm at CTC resulted in a significant $118,440 per additional life-year gained and accounted for more than half of all OC procedures. Moreover, working up these small, almost always benign polyps with OC caused considerable complications. The study found almost half of all OC-related complications were attributable to work-up of diminutive lesions. Furthermore, targeting these lesions did not improve screening efficacy, reducing CRC incidence by only 1.3 percent.

The authors say the data support "CTC with nonreporting of diminutive lesions" to be "the most cost-effective and safest screening option available." "Providing additional effective yet distinct screening options like CTC could encourage more adults to undergo screening," conclude the authors, and consequently "increase overall compliance with screening" for CRC.

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