Colon cancer screening
http://www.100md.com
《加拿大医疗协会学报》
I am a bit perplexed about the cost-effectiveness analysis of CRC screening by Steven Heitman and associates.1 First, it does not compare CT colonography with a "do nothing" approach nor does it take into consideration the recommendations of the Canadian Task Force on Preventive Health Care.2 What is the predicted cost-effectiveness, in Canada, of CT colonography as the alternative to doing nothing?
Second, the analysis seemingly presumes that either CT colonography or colonoscopy will be used exclusively. The authors indicate that current population screening rates are less than 20% but that a recent study has shown that up to 28% of the population would be willing to submit to CT colonography. The analysis should have included a population perspective on the benefits and costs of offering CT colonography to patients willing to submit to this strategy who would otherwise refuse screening altogether. Offering several screening methods may be the only way to increase population-wide adherence.
REFERENCES
Heitman SJ, Manns BJ, Hilsden RJ, et al. Cost-effectiveness of computerized tomographic colonography versus colonoscopy for colorectal cancer screening. CMAJ 2005;173(8):877-81.
Canadian Task Force on Preventive Health Care. Colorectal cancer screening: Recommendation statement from the Canadian Task Force on Preventive Health Care. CMAJ 2001;165(2):206-8.(Bryce Kiberd)
Second, the analysis seemingly presumes that either CT colonography or colonoscopy will be used exclusively. The authors indicate that current population screening rates are less than 20% but that a recent study has shown that up to 28% of the population would be willing to submit to CT colonography. The analysis should have included a population perspective on the benefits and costs of offering CT colonography to patients willing to submit to this strategy who would otherwise refuse screening altogether. Offering several screening methods may be the only way to increase population-wide adherence.
REFERENCES
Heitman SJ, Manns BJ, Hilsden RJ, et al. Cost-effectiveness of computerized tomographic colonography versus colonoscopy for colorectal cancer screening. CMAJ 2005;173(8):877-81.
Canadian Task Force on Preventive Health Care. Colorectal cancer screening: Recommendation statement from the Canadian Task Force on Preventive Health Care. CMAJ 2001;165(2):206-8.(Bryce Kiberd)