OBJECTIVES

: Colorectal cancer is the most diagnosed cancer and one of the most common cancer causes of death in the Czechia. A properly implemented screening program leads to a reduction in the burden of colorectal cancer (CRC) and thus to money savings. The objective of our study was to estimate cost of illness and evaluate cost-effectiveness of the screening program in the Czechia.

METHODS

: The study was based on individual national data from the National Registry of Reimbursed Health Services and the National Cancer Registry. The cost of CRC treatment was estimated by comparing all healthcare provided in the period 2010–2018 for cases and controls (persons with/without CRC). Costs were calculated by age, stage and clinical phase of the disease. Subsequently, the lifetime costs of individuals were estimated and included in the cost-effectiveness analysis (together with the specification of the natural history of the disease and the screening process) of three strategies (without screening, FIT screening or FIT/colonoscopy screening) using the Markov model.

RESULTS

: Through screening program, with a baseline participation of 45%, it is possible to reduce the incidence of CRC by 44% (FIT/colonoscopy) and 34% (FIT), respectively. Similar results can be observed for CRC mortality, where screening has the potential to reduce mortality by 47% and 39%, respectively. The increase in costs associated with the screening and follow-up diagnostics in screening scenarios is offset by a reduction in the cost of treatment of patients with CRC. In the cohort, which was offered FIT, the average costs per individual decreased by 3,101 CZK and in the cohort, which was also offered colonoscopy, even by 3,653 CZK compared to the cohort without screening.

CONCLUSIONS

: The presented study clearly demonstrated the cost-effectiveness and even cost savings for both screening strategies offered in the Czechia in comparison with the absence of screening.