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Resource use and costs of the low-risk arm of a risk-stratified colorectal cancer screening approach based on previous negative FIT values: comparative analyses with the standard approach
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DOI：10.1016/j.clcc.2026.05.005.png)
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Abstract
En 中文
• Risk-stratified colorectal cancer (CRC) utilising the cumulative faecal haemoglobin (f-Hb) values of previous faecal immunochemical tests (FIT) below positivity thresholds is a promising strategy due to its high predictive value and data availability. • Based on observational evidence, a pilot project has been started where participants with two consecutive negative FIT values are stratified into 3 risk groups: low-risk (cumulative f-Hb ≤ 3.8 μg/g faeces): 3-year screening interval; intermediate-risk (4 to 19.9 μg/g faeces): standard 2-year screening interval; high-risk (≥ 20 μg/g faeces): immediate colonoscopy or 1 year FIT. • By using retrospective data, this study focuses on the low-risk participants and estimates and compares resources and costs between standard screening (SS, 2-year interval) and risk-stratified protocol (RS) adopting an extended (4 years) interval. • The low-risk branch of this risk-stratified approach could result in an excess cost of 8.5% compared to the same group of participants following biennial standard strategy, mainly due to the increased cost of treatment. These findings need to be assessed in the context of the entire strategy, since the high-risk group could notably reduce treatment costs through earlier detection.
Keywords:
colorectal cancer screening
faecal immunochemical test
risk stratification
cost analysis
cumulative faecal haemoglobin
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