A recent cost-effectiveness analysis of 4 colorectal cancer screening initiatives found that some strategies may be more valuable than others in reducing screening disparities.
A recent cost-effectiveness analysis of 4 colorectal cancer screening initiatives found that some strategies may be more valuable than others in reducing screening disparities.
Screening rates for colorectal cancer remain lower than recommended, particularly for underserved populations like rural residents, African-Americans, and the uninsured. Researchers set out to model the costs and benefits of 4 potential interventions intended to expand access to cancer screening in North Carolina. Their results were published in Preventing Chronic Disease.
University of North Carolina researchers modeled the cost-benefit effects—with benefit measured as costs and years of life gained—of 4 proposed screening interventions, and compared the results to the benchmark of screening as usual.
In the model, all 4 interventions observed increased colorectal cancer screening, though the improvements were largest for the mailed reminders and the mass media campaign. These interventions were also the most cost-effective, as they would cost just $14.50 and $25.30, respectively, per additional life-year gained. The mass media campaign would result in 145,821 additional life-years gained over a 20-year period, while the mailed reminder initiative would result in a gain of 111,516 life-years. In comparison, the plan to expand endoscopy locations would cost over $210 per additional life-year and only result in around 14,000 additional life-years over 20 years.
As each intervention was designed to target a different population, they reduced disparities in screening rates differently. For instance, the “mailed reminders reduced the screening gap between Medicaid enrollees and the privately insured from 6.7 to 2.1 percentage points.” The mass media intervention reduced the racial gap in screening rates by about 1 percentage point, and the screening voucher closed the gap for the uninsured by the same amount. The endoscopy facility expansion did not increase overall screening rates or reduce county-level disparities in screening rates.
Overall, the researchers found that a combination of mailed reminders and mass media advertising would be the most effective strategy to address disparities and improve screening rates. While the total cost would surpass $5.3 million, this intervention would result in 257,306 additional life-years gained over a 20-year period, for a cost per additional life-year of just $20.60.
“A model such as this provides a useful foundation for informing intervention approaches, and it can be updated to support further integration of new data on costs, screening assumptions, and emerging evidence on best practices, with re-analysis informing ongoing intervention decisions,” the authors conclude. “Over time, as progress is made toward addressing disparities and closing gaps in screening, updating and re-analyzing the model could chart a dynamic course toward efficiently meeting established population health targets.”
Symptom Documentation Differences in Acute Cancer Care Suggest Sociodemographic Disparities
April 22nd 2025Researchers are calling for more targeted efforts to improve health equity after a new analysis revealed that cancer symptom documentation and burden vary across certain demographics.
Read More
Exploring Racial, Ethnic Disparities in Cancer Care Prior Authorization Decisions
October 24th 2024On this episode of Managed Care Cast, we're talking with the author of a study published in the October 2024 issue of The American Journal of Managed Care® that explored prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.
Listen
Rare Autoimmune Disorder Linked With Increased Risk of Certain Skin Cancers
April 21st 2025The risk of some skin cancers, including squamous cell carcinoma, basal cell carcinoma, and non-melanoma skin cancer, was particularly heightened among patients with severe mucous membrane pemphigoid.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
NCCN Data Find Racial, Socioeconomic Disparities in Quality of Care for Metastatic Pancreatic Cancer
April 9th 2025New data from the National Comprehensive Cancer Network (NCCN) reveal that socially vulnerable and minority patients with metastatic pancreatic cancer are less likely to receive recommended treatments and achieve longer survival.
Read More