Colonoscopy Every 10 Years Starting at Age 40 Modeled as Cost-Effective for Men With Body Mass Index ≥35
By

Colonoscopy Every 10 Years Starting at Age 40 Modeled as Cost-Effective for Men With Body Mass Index ≥35

Douglas K. Rex, MD, MASGE, reviewing Yeoh A, et al. Clin Gastroenterol Hepatol 2022 Aug 4.

Obesity is a known risk factor for colorectal cancer (CRC) in both men and women. A previously developed decision analytic was used to model the cost-effectiveness of performing colonoscopy every 5 or 10 years or fecal immunochemical test (FIT) screening every year in overweight and obese individuals, beginning at age 40, 45, or 50 through age 75, with 100% adherence. 

Colonoscopy starting at age 45 or FIT starting at 40 was cost-effective using a threshold of $100,000 per quality-adjusted life year (QALY) gained for all body mass index (BMI) groups and both sexes. Colonoscopy every 10 years was always preferred over colonoscopy every 5 years.  

Colonoscopy every 10 years starting at age 40 was cost-effective for men with BMI ≥35, with $93,300 per QALY for BMI 35 to <40 and $80,400 per QALY for BMI ≥40.

Douglas K. Rex, MD, FASGE

COMMENT

Our colonoscopy guidelines adjust the age to begin screening and the screening interval only for family history. Cigarette smoking, obesity, and diabetes are all associated with increased CRC risk. This study suggests that beginning colonoscopy at age 40 in men with BMI ≥35 meets accepted cost-effectiveness thresholds.

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.

CITATION(S)

Yeoh A, Mannalithara A, Ladabaum U. Cost-effectiveness of earlier or more intensive colorectal cancer screening in overweight and obese patients. Clin Gastroenterol Hepatol 2022 Aug 4. (Epub ahead of print) (https://doi.org/10.1016/j.cgh.2022.07.028)

Related Posts

Scroll to Top