To determine whether, given a limited budget, a state's low‐income uninsured population would have greater benefit from a colorectal cancer () screening program using colonoscopy or fecal immunochemical testing ().
South Carolina's low‐income, uninsured population.
Comparative effectiveness analysis using microsimulation modeling to estimate the number of individuals screened, cases prevented, deaths prevented, and life‐years gained from a screening program using colonoscopy versus a program using annual in South Carolina's low‐income, uninsured population. This analysis assumed an annual budget of $1 million and a budget availability of 2 years as a base case.
The annual screening program resulted in nearly eight times more individuals being screened, and more important, approximately four times as many deaths prevented and life‐years gained than the colonoscopy screening program. Our results were robust for assumptions concerning economic perspective and the target population, and they may therefore be generalized to other states and populations.
A screening program will prevent more deaths than a colonoscopy‐based program when a state's budget for screening supports screening of only a fraction of the target population.
Data Sources/Study Setting