Cost-Effectiveness of Blood-Based Biomarkers for Colorectal Cancer Screening—An Ounce of Prevention Is Worth a Pound of Cure
Menée aux Etats-Unis à l'aide d'un modèle de simulation, cette étude estime le rapport coût-efficacité de cinq stratégies de dépistage du cancer colorectal (coloscopie, biopsie liquide, biopsie liquide après non observance de la coloscopie, test FIT et test ADN fécal) par rapport à l'absence de dépistage
There are several timely, important, and novel aspects to colorectal cancer (CRC) screening that are highlighted in the study by Aziz et al. Despite good evidence to illustrate the reduction in CRC mortality associated with screening, adherence to screening still falls short of the goal of 80% across all populations. For this reason, it makes sense to develop more acceptable tests that avoid the colon cleansing or sedation associated with colonoscopy, obtaining the specimen for fecal immunochemical testing (FIT), or other barriers to completion of CRC screening. Moreover, prior studies have demonstrated differential preferences and uptake of CRC screening tests that contribute to the racial and ethnic disparities in health care outcomes. Compared with White people, people of other races and ethnicities (eg, Asian, Black, and Hispanic or Latinx people) adhere more often to noncolonoscopy tests. Studies have demonstrated that blood tests for cancer screening may be more acceptable than other screening tests, such as FIT that detects human blood in stool or colonoscopy that requires a cathartic to cleanse the bowel to allow direct visualization of the colon lining. Thus, this study by Aziz and colleagues examines an important step in the dissemination of new technologies to improve cancer screening and possibly reduce racial and ethnic disparities in CRC outcomes.
JAMA Network Open , éditorial en libre accès, 2022