{"id":6803,"date":"2019-10-28T08:16:49","date_gmt":"2019-10-28T07:16:49","guid":{"rendered":"https:\/\/www.endoscopy-campus.com\/?post_type=ec-news&p=6803"},"modified":"2019-10-28T08:16:50","modified_gmt":"2019-10-28T07:16:50","slug":"modeling-study-shows-current-surveillance-colonoscopy-paradigms-are-cost-effective","status":"publish","type":"ec-news","link":"https:\/\/www.endoscopy-campus.com\/en\/ec-news\/modeling-study-shows-current-surveillance-colonoscopy-paradigms-are-cost-effective\/","title":{"rendered":"Modeling Study Shows Current Surveillance Colonoscopy Paradigms Are Cost-Effective"},"content":{"rendered":"\n

Douglas K. Rex, MD, FASGE reviewing Meester RGS, et al. Ann Intern Med 2019 Sep 24.<\/em><\/p>\n\n\n\n

Some modeling studies suggest that surveillance colonoscopy in patients with low-risk adenomas (1 or 2 tubular adenomas <10 mm with low-grade dysplasia) is not cost-effective.<\/p>\n\n\n\n

In a new modeling study, low-risk adenomas were defined as 1 to 2 tubular adenomas <10 mm in size. Patients with adenomas received no further screening or surveillance, routine screening after 10 years, low-intensity surveillance (10 years after low-risk adenoma removal and 5 years after high-risk adenoma removal), or high-intensity surveillance (5 years after low-risk adenoma removal and 3 years after high-risk adenoma removal).<\/p>\n\n\n\n

The model suggested that for patients who had low-risk adenomas removed, subsequent colonoscopic screening reduced colorectal cancer risk by 39%, low-intensity surveillance reduced risk by 46%, and high-intensity surveillance reduced risk by 55%. The incremental cost-effectiveness ratio was $4,000 per quality-adjusted life-year (QALY) gained when patients with low-risk adenomas went from return-to-screening to low-intensity surveillance and $18,400 per QALY gained for high-intensity versus low-intensity surveillance. For patients who had high-risk adenomas removed, the incremental cost-effectiveness ratio for high-intensity versus low-intensity surveillance was $8,400 per QALY gained.<\/p>\n\n\n\n

Sensitivity analyses showed that cost-effectiveness ratios were below accepted thresholds over most scenarios.<\/p>\n\n\n\n

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COMMENT
As a colonoscopist, it is encouraging to see a modeling study suggest that even average performance of colonoscopy with currently recommended surveillance intervals is a cost-effective medical practice. As adenoma detection rates continue to rise and recommended surveillance intervals are lengthened, cost-effectiveness of surveillance colonoscopy will improve further. <\/p><\/blockquote><\/figure>\n\n\n\n

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Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made. <\/p>\n\n\n\n

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Douglas K. Rex, MD, FASGE <\/p>\n<\/div><\/div>\n\n\n\n

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CITATION(S) <\/h2>\n\n\n\n

Meester RGS, Lansdorp-Vogelaar I, Winawer SJ, Zauber AG, Knudsen AB, Ladabaum U. High-intensity versus low-intensity surveillance for patients with colorectal adenomas: a cost-effectiveness analysis.\u00a0Ann Intern Med<\/em>\u00a02019 Sep 24. (Epub ahead of print) (https:\/\/doi.org\/10.7326\/M18-3633<\/a>) <\/p>\n","protected":false},"excerpt":{"rendered":"

Douglas K. Rex, MD, FASGE reviewing Meester RGS, et al. Ann Intern Med 2019 Sep 24. Some modeling studies suggest that surveillance colonoscopy in patients with low-risk adenomas (1 or 2 tubular adenomas <10 mm with low-grade dysplasia) is not cost-effective. In a new modeling study, low-risk adenomas were defined as 1 to 2 tubular … Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,1769],"tags":[],"class_list":["post-6803","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-asge-kolon"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/6803","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=6803"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=6803"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=6803"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}