Background/Objectives:Colorectal cancer is the most frequently diagnosed cancer and second by mortality among all cancers in Croatia. The Organized National Colorectal Cancer Screening Program was introduced by the government in 2007. It targets individuals aged 50–74 years with a biennial screening with a guaiac fecal occult blood test (gFOBT). The aim of this study is to analyze the costs associated with colorectal cancer in Croatia and to compare the cost-effectiveness of three screening strategies: no screening, biennial gFOBT, and biennial fecal immunochemical testing (FIT).Patients and methods:A model was developed to compare the three screening scenarios. The model simulated a cohort of 10,000 patients aged 50 years without colorectal cancer. Health outcomes and associated costs were projected over a five-year time horizon. The model outcomes include the number of newly diagnosed colorectal cancer cases, number of colorectal cancer-related deaths, life-years gained, and costs per life-year gained.Results:The average five-year costs per patient for the treatment of advanced cancer are EUR 39,802, which is substantially higher than the average costs of EUR 16,897 per patient across all stages. The implemented model indicates that both screening options yielded improved health outcomes at lower costs compared with no screening. FIT is considered the preferred screening option due to its higher sensitivity, greater health outcomes, and lower costs relative to gFOBT.Conclusions:The introduction of FIT screening instead of gFOBT could increase screening uptake for colorectal cancer, improve health outcomes, and reduce healthcare expenditures and the economic burden associated with colorectal cancer in Croatia.
背景/目的：结直肠癌是克罗地亚发病率最高、死亡率居第二位的恶性肿瘤。该国政府于2007年启动了全国性结直肠癌筛查计划，针对50-74岁人群每两年进行一次愈创木脂粪便隐血试验筛查。本研究旨在分析克罗地亚结直肠癌相关医疗成本，并比较三种筛查策略的成本效益：不筛查、两年期gFOBT筛查及两年期粪便免疫化学检测筛查。 患者与方法：通过构建模型对比三种筛查方案，模拟了10,000名50岁未患结直肠癌人群队列。研究以五年期为观察范围，预测健康结果及相关成本。模型产出指标包括新发结直肠癌病例数、结直肠癌相关死亡数、获得生命年数及每获得一个生命年的成本。 结果：晚期结直肠癌患者五年期人均治疗成本达39,802欧元，显著高于各分期患者16,897欧元的平均成本。模型显示两种筛查方案均能以更低成本获得更优健康结果。相较于gFOBT，FIT因具有更高敏感性、更佳健康产出及更低成本，被视为更优筛查方案。 结论：在克罗地亚采用FIT替代gFOBT进行筛查，可提升结直肠癌筛查覆盖率，改善健康结局，同时降低医疗支出及结直肠癌相关经济负担。
The Cost-Effectiveness of Organized National Colorectal Cancer Screening Program in Croatia
肿瘤(癌症)患者之家