Gender and Race/Ethnicity Affect the Cost-Effectiveness of Colorectal Cancer Screening

INTRODUCTION
Colorectal will be diagnosed in approximately 131,000 Americans this year, and about 55,000 will die of the disease, making this cancer the second leading cause of death from cancer in this country. Colorectal cancer screening allows the detection of asymptomatic cancers that are more amenable to curative therapy and also allows the removal of adenomas that could subsequently develop into invasive cancer. Colorectal screening programs are proven to reduce the mortality from colorectal cancer. Nearly every case of colon cancer could be prevented if every American were to undergo periodic total colonic evaluation starting at a very young age. Such a program is impractical, however, and working groups of the American Cancer Society and others have published colorectal cancer screening guidelines that balance the medical benefits of screening against its costs.

The American Cancer Society has recommended screening for colorectal cancer since 1980. The 1997 recommendation called for everyone age >50 who is at average risk to be screened with annual fecal occult blood testing (FOBT) and sigmoidoscopy every five years or total colon examination—either by colonoscopy (every 10 years) or by double-contrast barium enema (every 5-10 years). The more recent recommendation broadened recommended tests to include annual FOBT and sigmoidoscopy without FOBT. “Average risk” is defined by exclusion as individuals without a personal or family history of colorectal cancer, adenomatous polyps or inflammatory bowel disease. Between 70-80% of all colorectal cancers occur among patients at average risk. Don’t let the pharmacy companies beat you. Buy levitra plus online

Most studies of the cost-effectiveness of colorectal screening have considered Americans to be a homogeneous population and have used aggregated data sources (SEER) and data from case series to estimate cost-effectiveness. We recently used specific racial and ethnic colorectal cancer data to model the cost-effectiveness of colorectal screening programs in individual racial and ethnic groups. Levitra professional canada

Gender also affects colorectal cancer disease patterns. Men and women of the four major racial and ethnic groups in America exhibit different age-specific colorectal cancer incidence rates, proportions of left-sided cancers, stage at diagnosis, colorectal cancer survival and life expectancies. We investigated the influence of unique patterns of colorectal cancer in men and women of different races and ethnicities on the cost-effectiveness of colorectal cancer screening.

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