Featured Research

from universities, journals, and other organizations

Surveillance colonoscopy should be targeted to high-risk patients

Date:
June 21, 2010
Source:
American Gastroenterological Association
Summary:
Surveillance colonoscopy is effective and cost-effective when targeted to high-risk patients, according to new research. However, overuse of surveillance colonoscopy could be excessively costly or even harmful.

Surveillance colonoscopy is effective and cost-effective when targeted to high-risk patients, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute. However, overuse of surveillance colonoscopy could be excessively costly or even harmful.

"Surveillance colonoscopy is a widely accepted and utilized practice that has the potential to decrease the burden of colorectal cancer. Yet, this practice also carries considerable monetary and resource costs as well as the risk of procedure-related complications," said Sameer Dev Saini, MD, MS, of the Ann Arbor VA Health Services Research & Development Center of Excellence and lead author of the study. "Despite these concerns, data supporting the long-term effectiveness of surveillance colonoscopy and the choice of optimal surveillance strategy are limited."

Current guidelines recommend that patients with colonic adenomas undergo periodic surveillance colonoscopy. Surveillance colonoscopies are performed to examine the colon after a colorectal abnormality, either cancerous or benign, has been detected and removed. But, is doing so cost effective? Dr. Saini and colleagues sought to answer this question by using existing data to make projections about the effectiveness and cost utility of surveillance. They developed a Markov model based on published literature to study various surveillance strategies from the perspective of a long-term payor (the target population was 50-year-old patients with newly diagnosed colonic adenomas followed until death).

According to study results, colonoscopy every three years in high-risk patients and every 10 years in low-risk patients (3/10 strategy) was more costly, but also more effective than no surveillance (incremental cost-effectiveness ratio [ICER] of $5,743 per quality-adjusted life year [QALY] gained). A cost-utility analysis suggested that the 3/10 strategy is the optimal strategy under the vast majority of clinical circumstances.

A 3/5 strategy (colonoscopy every three years in high-risk patients and every five years in low-risk patients) was considerably more costly, but only marginally more effective (ICER of $296,266 per QALY). This strategy may be reasonable in populations in which a low-risk subgroup cannot be reliably identified or if the miss rate for advanced adenomas is believed to be very high (at least 14 percent). Compared to the 3/10 strategy, the 3/5 strategy resulted in five fewer cancers and one fewer cancer-related death per 1,000 patients entering surveillance.

A 3/3 strategy (colonoscopy every three years in both high- and low-risk patients), which may be attractive to gastroenterologists with medico-legal concerns over missed neoplasia, is cost-ineffective and potentially harmful in comparison to less intensive surveillance. Compared to the 3/5 strategy, the 3/3 strategy resulted in two fewer cancers and one fewer cancer-related death per 1,000 patients entering surveillance.

In the future, improvements in risk stratification could further enhance physicians' ability to target surveillance to those patients most likely to benefit from this practice.


Story Source:

The above story is based on materials provided by American Gastroenterological Association. Note: Materials may be edited for content and length.


Journal Reference:

  1. Sameer D. Saini, Philip Schoenfeld, Sandeep Vijan. Surveillance Colonoscopy Is Cost-Effective for Patients With Adenomas Who Are at High Risk of Colorectal Cancer. Gastroenterology, 2010; 138 (7): 2292 DOI: 10.1053/j.gastro.2010.03.004

Cite This Page:

American Gastroenterological Association. "Surveillance colonoscopy should be targeted to high-risk patients." ScienceDaily. ScienceDaily, 21 June 2010. <www.sciencedaily.com/releases/2010/06/100621111244.htm>.
American Gastroenterological Association. (2010, June 21). Surveillance colonoscopy should be targeted to high-risk patients. ScienceDaily. Retrieved April 17, 2014 from www.sciencedaily.com/releases/2010/06/100621111244.htm
American Gastroenterological Association. "Surveillance colonoscopy should be targeted to high-risk patients." ScienceDaily. www.sciencedaily.com/releases/2010/06/100621111244.htm (accessed April 17, 2014).

Share This



More Health & Medicine News

Thursday, April 17, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Could Even Casual Marijuana Use Alter Your Brain?

Could Even Casual Marijuana Use Alter Your Brain?

Newsy (Apr. 16, 2014) A new study conducted by researchers at Northwestern and Harvard suggests even casual marijuana use can alter your brain. Video provided by Newsy
Powered by NewsLook.com
Thousands Of Vials Of SARS Virus Go Missing

Thousands Of Vials Of SARS Virus Go Missing

Newsy (Apr. 16, 2014) A research institute in Paris somehow misplaced more than 2,000 vials of the deadly SARS virus. Video provided by Newsy
Powered by NewsLook.com
Formerly Conjoined Twins Released From Dallas Hospital

Formerly Conjoined Twins Released From Dallas Hospital

Newsy (Apr. 16, 2014) Conjoined twins Emmett and Owen Ezell were separated by doctors in August. Now, nearly nine months later, they're being released from the hospital. Video provided by Newsy
Powered by NewsLook.com
Ebola Outbreak Now Linked To 121 Deaths

Ebola Outbreak Now Linked To 121 Deaths

Newsy (Apr. 15, 2014) The ebola virus outbreak in West Africa is now linked to 121 deaths. Health officials fear the virus will continue to spread in urban areas. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins