Cost-Effectiveness of Colonoscopy in Screening for Colorectal Cancer

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   Figure 1. Influence of compliance with repeated fecal occult blood testing (FOBT) once per year (left) and repeated colonoscopy (right) once per decade on the incremental cost-effectiveness ratio compared with no screening.
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   Figure 2. Influence of the sensitivity and specificity of fecal occult blood testing (FOBT) on the incremental cost-effectiveness ratio compared with no screening.
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   Figure 3. Efficacy of colonoscopy in preventing colorectal cancer and its influence on the incremental cost-effectiveness ratio of fecal occult blood testing (dotted line) and colonoscopy (solid line) compared with no screening.
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   Appendix Figure. The black and gray ovals represent Markov states in which patients remain for at least a full 1-year cycle. The white ovals represent intermediate states of screening procedures, which patients may enter and leave during one cycle. The arrows represent transitions between various states. Markov states in screening for colorectal cancer (CRC) by fecal occult blood test (FOBT) (top), flexible sigmoidoscopy (middle), and colonoscopy (bottom).

• Copyright ©2004 by the American College of Physicians