Economic Evaluation of Mailing Self-Sampling qFIT Kits to Non-Participants in Colorectal Cancer Screening in the Czech Republic

OBJECTIVES: Colorectal cancer (CC) screening programme was initiated in 2000 in the Czech Republic; however it has not yet achieved sufficient participation of eligible population. A pilot project was conducted to increase participation in the programme by mailing self-sampling qFIT kits to non-participants. This study aimed to perform an economic evaluation of the costs and benefits of this screening strategy.

METHODS: The project recruited 9,962 eligible persons (men and women aged 50–70 years, without recent participation in the CC screening programme and no previous treatment associated with colorectal lesions or cancer). Based on the individual data from the project, the Czech National Health Information System and results from the literature, simplified natural history of the disease was modelled. Costs and characteristics of the screening process through self-sampling kits and lifetime cost of CC treatment were estimated. The primary outcome was a cost-benefit analysis of the screening strategy.

RESULTS: The total cost for all recruited persons for the screening process through self-sampling qFIT kits was 57,000 EUR. The model evaluation showed that 6 colorectal cancers were prevented by this screening strategy. The lifetime cost of treating one CC was approximately 32,500 EUR and the total estimated savings for treating 6 colorectal cancers was approximately 198,500 EUR. When comparing the total cost of the screening process and the potential cost savings from prevented cancer treatment, this screening approach appears to be cost-saving.

CONCLUSIONS: The direct mailing of qFIT kits appears to be a potentially cost-saving method, which could be considered as an alternative to the standard invitation to physician, which is currently practised in the Czech CC screening programme.