Volume 50 | Number 3 | June 2015

Abstract List

Alex Steen M.Sc., Amy B. Knudsen Ph.D., Frank Hees M.Sc., Gailya P. Walter M.P.H., Franklin G. Berger Ph.D., Virginie G. Daguise Ph.D., Karen M. Kuntz Sc.D., Ann G. Zauber Ph.D., Marjolein Ballegooijen Ph.D., Iris Lansdorp‐Vogelaar Ph.D.


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 ().

Data Sources/Study Setting

South Carolina's low‐income, uninsured population.

Study Design

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.

Principal Findings

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.