OBJECTIVE
To evaluate the effectiveness of the colorectal cancer (CRC) screening model using risk groups.
MATERIAL AND METHODS
The comparison of effectiveness of two CRC screening models has been conducted, namely the main model, according to which screening is carried out within the framework of the population’s medical checkup, and the model considering risk factors, with which additional selection of patients is made on the basis of a specialized questionnaire. Basic parameters for the models were the average results of the CRC pilot screening projects, in which 6393 respondents participated, all of them filled out the questionnaire and were conditionally divided into 3 risk groups. The high-risk group of CRC development ranged from 2.1% to 3.6%, moderate — from 34.6% to 36.1%, the biggest low-risk group — from 58% to 63%.
RESULTS
Risk-based CRC screening model compared to the main model provides better detection of colorectal neoplasia. Thus, the detection of new CRC cases is 0.18% in the main model, 0.23% in the risk-based model, polyps’ recognition is 3.2% and 4.4% respectively. Even though the costs of screening predicted by the risk-based model were greater by 6.5% compared to the results of the main model, the unit costs of one neoplasia detection were 13% less. The costs of early detection, including diagnosis and treatment, take into consideration the costs of screening as well as of its implementation consequences. Simulation modelling of CRC screening using risk groups showed higher total costs for screening and treatment of new CRC cases, but for 1 CRC case the costs were less by almost 6% or 60 thousand rubles. The costs for 1 case of detection and treatment of CRC are comparable to the gross domestic product (GDP) per capita value, namely 927.5 thousand rubles in 2021, 1045.5 thousand rubles — in 2022 based on the Federal State Statistics Service data. According to the methodologies used by the World Health Organization for medical technologies evaluation, technologies are considered economically viable if the costs per unit of result do not exceed one to three GDP per capita.
CONCLUSION
The study of survey’s possibilities with subsequent development of guidelines on the organization of colorectal cancer screening should be continued in order to preliminary differentiate patients by risk groups.
