Lowering CRC screening age to 40 years could result in up to 7,988 fewer deaths in Canada
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Key takeaways:
- Lowering the colorectal cancer screening age to 45 or 40 years resulted in 5,261 and 7,988 fewer deaths.
- The cost per quality-adjusted life-year decreased to $762 and $2,622, respectively.
A microsimulation model showed a reduction in colorectal cancer disease burden and mortality when screening for CRC was initiated at ages 45 years or 40 years, which also added life-years to the population at a comparable health care cost.
“We are seeing a rising incidence of new colorectal cancers in people under the age of 50,” Jonathan M. Loree, MD, study author and medical oncologist at BC Cancer, told Healio. “In order for a screening test to be funded, it’s important to generate health economic data to provide information about how much a new program will cost and whether it is cost-effective. We wanted to generate that data to help inform health systems of the value of implementing earlier screening.”
Using a microsimulation tool led by the Canadian Partnership Against Cancer, researchers conducted an economic evaluation computational study to estimate the association of a lowered CRC screening age with incidence, mortality and health care costs.
They used the 1968 to 1972 birth cohort as a reference and based their analysis on four birth cohorts (1973-1977, 1978-1982, 1983-1987 and 1988-1992), accounting for the effects of increasing CRC incidence among younger birth cohorts.
According to the microsimulation, screening initiated at age 45 years resulted in 12,188 fewer cases of CRC, 5,261 fewer CRC-related deaths and 92,112 additional quality-adjusted life-years (QALYs) in the cohorts over a 40-year period, compared with screening at age 50 years. Screening at age 40 years resulted in 18,135 fewer cases, 7,988 fewer deaths and an added 150,373 QALYs.
The cost per QALY decreased when those born from 1988 to 1992 initiated screening at ages 45 years ($762 per QALY) or 40 years ($2,622 per QALY).
“Initiation of screening at an earlier age will save a significant number of lives and appears highly cost-effective,” Loree said. “This is a great example where preventive health interventions are highly efficacious and cost-effective.”
Loree continued: “[The results] provide the information needed to start the discussion around whether we should lower the screening age in Canada and will hopefully help discussions in other public health care systems.”
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