Comparison of colorectal cancer screening methods for commercially insured patients

In the United States, colorectal cancer (CRC) is the fourth most common cancer diagnosed among men and women and the second leading cause of death from cancer. The majority of cases of CRC can be prevented by the detection and removal of noncancerous adenomatous polyps. As in other types of cancer, survival is significantly better when CRC is diagnosed early while the disease is still localized.

Although optical colonoscopy has been the dominant method for CRC screening in the United States to date, there are other methods recommended by established guidelines. These include computed tomography (CT) colonography, guaiac-based fecal occult blood test, fecal immunochemical test-DNA, flexible sigmoidoscopy, and flexible sigmoidoscopy with fecal immunochemical test. Offering patients choices for CRC screening appears to lead to higher screening rates and better screening compliance.

CT colonography’s effectiveness, its associated patient advantages, and its potential role to increase CRC screening rates have been demonstrated in previous research, but whether CT colonography has a cost advantage relative to optical colonoscopy for the commercially insured U.S. population has not been assessed.

This research report by Milliman’s consultants compares the costs of CRC screening using CT colonography or optical colonoscopy for commercially insured people in the United States.

Dr. Judy Yee, chair of the Department of Radiology at Montefiore Medical Center, also co-authored this report.

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