Cost of Increasing Years-of-Life-Gained (YLG) Using Fecal Immunochemical Testing as a Population-Level Screening Model in a Rural Appalachian Population.
cancer
colorectal
cost
rural
screening
Journal
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
ISSN: 1748-0361
Titre abrégé: J Rural Health
Pays: England
ID NLM: 8508122
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
pubmed:
21
10
2020
medline:
30
10
2021
entrez:
20
10
2020
Statut:
ppublish
Résumé
Given the innovation of fecal immunochemical testing (FIT) to detect polyps in the rectum and colon for removal by colonoscopy, it is important to determine the cost per Life-Year Gained (LYG) when using FIT as a population-level screening model. This is particularly true for medically underserved rural populations. Accordingly, the purpose of this study was to make this determination among rural Appalachians experiencing isolation and economic challenges. The study occurred in an 8-county area of southeastern Kentucky. Kits were distributed to 1,424 residents. Seven hundred thirty-two kits (51.4%) were completed and returned. A Markov decision-analytic model was developed using PrecisionTree 7.6. Reactive test results occurred for 144 of the completed kits (19.7%). Thirty-seven colonoscopies were verified, with 15 of these indicating precancerous changes or actual cancer. Program costs were estimated at $461,952, with the average cost per person screened estimated at $324. Cost per LYG was $7,912. In contrast to an average cost per LYG of $17,200, our findings suggest a highly favorable cost-effectiveness ratio for this population of medically underserved rural residents. Cost-benefit analyses suggest that the screening program begins to yield positive net benefits at the stage when project recipients undergo colonoscopy, suggesting that this is the key step for behavioral intervention and intensified outreach.
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
576-584Informations de copyright
© 2020 National Rural Health Association.
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