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Based on consistent evidence from observational studies of a very strong risk reduction of colorectal cancer (CRC) incidence and mortality following endoscopic screening examinations (sigmoidoscopy, colonoscopy), these are now included in many expert screening recommendations.^1-2 However, there is ongoing debate regarding the optimal age, time intervals, and number of screening examinations. This particularly applies to colonoscopy, which is more effective than other screening modalities at decreasing CRC-related incidence and mortality. The recent study of Sonnenberg and Delcò³ comparing the cost-effectiveness of 2 screening programs based on a single or repeated colonoscopy makes a valuable contribution to this ongoing debate.

Sonnenberg and Delcò used computer models of a Markov process to assess life-years saved and incremental cost-effectiveness ratios of screening compared with no screening. The baseline assumptions were based on pertinent literature, and they were varied over relevant ranges of values in carefully conducted sensitivity analyses. In particular, the efficacy of . . . [Full Text of this Article]

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Cost-effectiveness of a Single Colonoscopy in Screening for Colorectal Cancer
Amnon Sonnenberg and Fabiola Delcò
Arch Intern Med. 2002;162(2):163-168.
ABSTRACT | FULL TEXT