Fecal Immunochemical Test Screens for Colon Cancer

A test that detects blood in the stool is the most cost effective method for screening for colon cancer. An economic evaluation of screening methods for colorectal cancer found that annual testing by the fecal immunochemical methods was more effective than other methods.

The fecal immunochemical test has high sensitivity and specificity, and might improve participation rates through increased patient acceptability. This would reduce the risk of colorectal cancer and colorectal cancer related deaths, and reduce healthcare costs in comparison to all other screening strategies and to no screening. In a model devised by scientists at University of Calgary, (Alberta, Canada), the authors used an incremental cost utility analysis, a sophisticated modeling technique, and two hypothetical patient cohorts (individuals with an "average risk,” i.e., no family history of colorectal cancer, aged 50-64 and 65-75) to compare different colorectal cancer screening methods.

The authors found that annual fecal immunochemical testing was more effective and less costly compared to all strategies (including no screening). Using this screening modality, among the lifetimes of 100,000 average-risk patients, the number of deaths from colorectal cancer was reduced from 1,393 to 457. Even after the authors accounted for many different scenarios, screening for colorectal cancer with fecal immunochemical testing remained the most cost effective screening option.

Clinical guidelines recommends screening for colorectal cancer in average risk individuals from 50 years old, yet some countries, such as the UK, do not currently have population-based colorectal cancer screening. In addition, many countries with colorectal cancer screening programs do not offer a choice of screening method. The authors concluded: "Health policy decision makers should consider prioritizing funding for colorectal cancer screening using fecal immunochemical testing." The study was published online on November 23, 2010, in the open access journal Public Library of Science (PLoS) Medicine.

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