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Cost-effectiveness of screening for bowel cancer

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Increasing bowel cancer testing rates through a general practitioner-organised health care package would reduce incidence and prove cost-effective

Treating bowel cancer is expensive, and the cost is rising rapidly. In the past decade, costs have increased for treating cancers at all stages (in particular, Stages 3 and 4), largely due to increased chemotherapy options and the introduction of more effective but expensive drug regimens.1 Increased treatment costs are a stimulus for the considerable effort in the areas of prevention and early detection.

The National Bowel Cancer Screening Program (NBCSP), based on a faecal occult blood test (FOBT), was introduced in mid 2006 to people aged 55 and 65 years, and was extended in 2009 to include people aged 50 years. It is due to be further expanded to biennial testing in 2020, with gaps filled annually until then.2 This delay in full implementation is related to the perceived cost of the NBCSP as well as infrastructure and logistical difficulties.3

There are concerns with aspects of the structure of the NBCSP, such as the target age group and screening intervals.3 Incidence of bowel cancer for people aged 40 to 50 years is rising,4 and recent evidence suggests that the incidence for people aged under 40…