Costs of colorectal cancer screening provision in CDC’s Colorectal Cancer Control Program: Comparisons of colonoscopy and FOBT/FIT based screening

• Published in: Evaluation and program planning 2017-06, Vol.62, p.73-80
• Main Authors: Subramanian, Sujha, Tangka, Florence K.L., Hoover, Sonja, Royalty, Janet, DeGroff, Amy, Joseph, Djenaba
• Format: Article
• Language: English
• Subjects: Activity-based costing; Averages; Cancer; Colonoscopy; Colorectal cancer; Colorectal cancer screening; Cost analysis; Economic evaluation; Medical screening; Program Administration; Screening cost; Tracking
• ISSN: 0149-7189; 1873-7870
• DOI: 10.1016/j.evalprogplan.2017.02.007

•Three years of screening provision activity-based costs were assessed.•Largest cost categories were screening/diagnostic services and program management.•Screening budget allocations should include both clinical and nonclinical costs. We assess annual costs of screening provision activities implemented by 23 of the Centers for Disease Control and Prevention’s Colorectal Cancer Control Program (CRCCP) grantees and report differences in costs between colonoscopy and FOBT/FIT-based screening programs. We analysed annual cost data for the first three years of the CRCCP (July 2009–June 2011) for each screening provision activity and categorized them into clinical and non-clinical screening provision activities. The largest cost components for both colonoscopy and FOBT/FIT-based programs were screening and diagnostic services, program management, and data collection and tracking. During the first 3 years of the CRCCP, the average annual clinical cost for screening and diagnostic services per person served was $1150 for colonoscopy programs, compared to $304 for FIT/FOBT-based programs. Overall, FOBT/FIT-based programs appear to have slightly higher non-clinical costs per person served (average $1018; median $838) than colonoscopy programs (average $980; median $686). Colonoscopy-based CRCCP programs have higher clinical costs than FOBT/FIT-based programs during the 3-year study timeframe (translating into fewer people screened). Non-clinical costs for both approaches are similar and substantial. Future studies of the cost-effectiveness of colorectal cancer screening initiatives should consider both clinical and non-clinical costs.