Integrated Sustainability Assessment of the Population-Based Colorectal Cancer Screening Program in Flanders
Author(s)
Bente Verhaegen, Master of Science in Healthcare Management.
Ghent University, Ghent, Belgium.
Ghent University, Ghent, Belgium.
OBJECTIVES: Given that the healthcare sector accounts for 4.4% of global net emissions, integrating environmental sustainability into health technology assessments (HTAs) is essential to align public health with environmentally sustainable development. This research aims to perform an integrated sustainability assessment of the Flemish population-based colorectal cancer (CRC) screening program. By assessing the social, economic, and environmental impacts from a care pathway perspective, decision-makers have a broader view to support the development of more sustainable, eco-friendly healthcare systems. Based on these findings, a generalized sustainability assessment approach is developed.
METHODS: A detailed care pathway was mapped to visualize every step in the CRC screening process, including invitation, reminders, diagnosis, communication, treatment and follow-up. For each step, the input and output flows were outlined and quantified to inform a forthcoming life cycle assessment (LCA). Observational data from the Flemish population were used to estimate transition probabilities within the care path. This pathway served as a foundation to model the three sustainability pillars. Methods for integrating environmental, economic, and social outcomes were identified through a targeted literature review.
RESULTS: In 2021, 853,009 citizens aged 50 to 74 were invited to the Flemish population-based CRC screening program, with a total participation rate of 53%. The modelling resulted in a total of about €184.9 million spend in healthcare costs. In addition, this group accounted for 730,880 quality-adjusted life years. The carbon footprint of a FIT test is approximately 0.27 kgCO₂e, while that of a colonoscopy is around 43.3 kgCO₂e. A detailed LCA of the full pathway is currently in progress.
CONCLUSIONS: A five-step sustainability assessment approach for health programs is proposed to promote holistic HTAs considering environmental impact supporting transparent and sustainable healthcare practices. Future work will incorporate comparator strategies, finalize the LCA, and apply integration methods to support sustainable and transparent healthcare decision-making.
METHODS: A detailed care pathway was mapped to visualize every step in the CRC screening process, including invitation, reminders, diagnosis, communication, treatment and follow-up. For each step, the input and output flows were outlined and quantified to inform a forthcoming life cycle assessment (LCA). Observational data from the Flemish population were used to estimate transition probabilities within the care path. This pathway served as a foundation to model the three sustainability pillars. Methods for integrating environmental, economic, and social outcomes were identified through a targeted literature review.
RESULTS: In 2021, 853,009 citizens aged 50 to 74 were invited to the Flemish population-based CRC screening program, with a total participation rate of 53%. The modelling resulted in a total of about €184.9 million spend in healthcare costs. In addition, this group accounted for 730,880 quality-adjusted life years. The carbon footprint of a FIT test is approximately 0.27 kgCO₂e, while that of a colonoscopy is around 43.3 kgCO₂e. A detailed LCA of the full pathway is currently in progress.
CONCLUSIONS: A five-step sustainability assessment approach for health programs is proposed to promote holistic HTAs considering environmental impact supporting transparent and sustainable healthcare practices. Future work will incorporate comparator strategies, finalize the LCA, and apply integration methods to support sustainable and transparent healthcare decision-making.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH149
Topic
Epidemiology & Public Health, Health Technology Assessment
Topic Subcategory
Public Health
Disease
Oncology