Favoring blood-based colorectal cancer tests over stool-based CRC screening could lead to higher costs and worse outcomes for patients, according to a recent study published in JAMA Network Open.
The study looked at patients in federally qualified healthcare settings and examined the benefits, costs and cost-effectiveness of noninvasive screening tests when adherence to a multistep screening process reflects adherence rates in populations receiving care, according to a report from The American Journal of Managed Care.
The FDA recently approved blood-based screening for CRC.
The cohort represented a predominantly Hispanic or Latino population. The simulated population had low adherence rates to key screening steps, including first-step noninvasive testing (45%), second-step follow-up colonoscopy after abnormal noninvasive results (40%) and ongoing surveillance colonoscopy for patients with high-risk findings (80%).
The main outcomes were CRC incidence and mortality, life years gained and quality-adjusted life years gained relative to no screening, costs and net monetary benefit.
Fecal tests emerged as the most effective and cost-effective colorectal cancer screening strategy, yielding 121 life years gained per 1,000 screened individuals and a net monetary benefit of $5,883 per person.
In contrast, blood testing was the least effective strategy, producing only 23 life years gained per 1,000 individuals and a negative net monetary benefit.