Stool DNA Tests Not Cost-Effective for Cancer Screening
Colorectal cancer testing method could be cost-effective if cost per test drops substantially
TUESDAY, Sept. 21 (HealthDay News) -- Screening Medicare beneficiaries for colorectal cancer (CRC) using stool DNA testing is not currently cost-effective, but could be if the cost per test dropped dramatically or if adherence to the testing were substantially better than for other screening tests, according to an analysis published in the Sept. 21 issue of the Annals of Internal Medicine.
Iris Lansdorp-Vogelaar, Ph.D., of the Erasmus Medical Center in Rotterdam, Netherlands, and colleagues used models based on Surveillance, Epidemiology, and End Results incidence rates, standard mortality and survival rates, and other data to simulate CRC rates in a large population and the effects of different screening strategies on life expectancy, lifetime costs, cost-effectiveness, and threshold costs.
Assuming a $350 cost per test, the researchers found that testing stool DNA every three or five years resulted in fewer added life-years and higher costs than the currently recommended screening strategies for CRC. There were no levels of sensitivity and specificity achieving cost-effectiveness at $350 per test, and the researchers calculated that stool DNA tests would not start to be cost-effective until the cost dropped to $40 to $60 per test for testing every three years. The researchers said DNA testing could be cost-effective at $350 per test if adherence were at least 50 percent higher than for other screening tests.
"Stool DNA testing could be a cost-effective alternative for CRC screening if the cost of the test substantially decreased or if its availability would entice a large fraction of otherwise unscreened persons to receive screening," the authors write.