Novel Noninvasive Tests for Colorectal Cancer Screening – A Cost-Effectiveness Analysis
AbstractBackground:. To compare cost-effectiveness of three novel noninvasive tests [multitarget stool RNA (mt-sRNA), multitarget stool DNA 2.0, and cell-free DNA] with guideline-recommended tests for colorectal cancer screening from payer’s perspective.Methods:. Outcomes of a hypothetical cohort of 100,000 individuals aged 45 years with average colorectal cancer risk (no prior colorectal cancer diagnosis, adenomatous polyps, or other disorders associated with a high lifetime risk of colorectal cancer) in the United States were simulated by a lifelong Markov model. Screening strategies included guideline-recommended strategies (colonoscopy, flexible sigmoidoscopy, computed tomographic colonography, fecal immunochemical test, high-sensitivity guaiac-based fecal occult blood testing, and multitarget stool DNA), three novel noninvasive tests, and no screening. Scenario analyses on perfect (100%) and test-specific adherence (reported real-world adherence) were conducted. Outcomes included
