Original Title: Sundhedsøkonomisk analyse af diagnostiske strategier ved symptomer på ende- og tyktarmskræft – en medicinsk teknologivurdering

Authors' objectives: The purpose of the analysis is to assess the health economic costs of selective colonoscopy versus initial colonoscopy. The main difference between the two strategies is that the diagnostic procedure flexible sigmoidoscopy, which forms part of the selective colonoscopy strategy, is replaced by the initial diagnostic procedure of colonoscopy in the initial colonoscopy strategy. A secondary purpose of the analysis is to assess whether the choice of strategy is shaped by differences in patient discomfort between flexible sigmoidoscopy and colonoscopy, or the risk of complications associated with diagnostic colonoscopy.

Authors' recommendations: Based on the cost analysis we conclude that: 1) there is no significant difference between the costs of the proposed initial colonoscopy strategy and the current selective colonoscopy strategy; 2) Initial colonoscopy entails less discomfort for the patient, partly because analgesics and sedatives are used, but more importantly because more patients avoid double examination; 3) the probability of an increase in complications due to an increase in the number of colonoscopies does not constitute a strong argument against the introduction of initial colonoscopy; 4) in the proposed strategy the number of patients who undergo more than one examination is reduced, and, consequently, the costs derived from lost earnings, transport, etc., are expected to decrease; 5) the proposed strategy is substantially less complicated. Compliance with the proposed strategy of initial colonoscopy should therefore exceed that of selective colonoscopy. In the light of the analysis outlined above, we recommended that initial colonoscopy be adopted as the preferred strategy in substitution for selective colonoscopy (initial flexible sigmoidoscopy).

Project Status: Completed

Year Published: 2009

URL for published report: https://www.sst.dk/-/media/Udgivelser/2009/Publ2009/MTV/tarmkraeft/MTV_tarmkraeft_net_final,-d-,pdf.ashx

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Denmark

Organisation Name: Danish Centre for Evaluation and Health Technology Assessment

Contact Address: National Board of Health, PO Box 1881, Islands Brygge 67, DK-2300 Copenhagen S, Denmark. Tel: 45 72 22 74 48; Fax: 45 72 22 74 07/67

Contact Name: dacehta@sst.dk

Contact Email: dacehta@sst.dk

Copyright: Danish Centre for Evaluation and Health Technology Assessment (DACEHTA)