Cost-effectiveness of colonoscopy and related procedures: population screening perspectives

Colorectal cancer (CRC) screening can reduce the incidence and mortality of CRC, many countries with moderate-to-high incidences CRC have implemented population programs. Colonoscopy plays a pivotal role in context as primary modality, diagnostic exam after positive noninvasive test, therapeutic procedure for resecting detected neoplasms, surveillance removal neoplastic lesions. Although colonoscopy outperforms other tests detecting colorectal it is associated higher cost, manpower, invasiveness. Owing to heterogeneity healthcare systems terms scale health revenue, demographics, payment each country, optimal or most cost-effective strategy may vary. Accordingly, economic appraisal different approaches essential, especially organized programs within which resources clinical capacity are constrained, step flow needs careful monitoring. The procedures applied manage screening-detected lesions subsequent also contribute substantial additional costs. level willingness pay affected by various factors, including income, educational level, consciousness, largely affects strategies. Herein, we systematically review summarize current evidence regarding cost-effectiveness colonoscopic screening, related procedures, provide balanced view from perspective It was revealed that 10-year effective compared strategies under willingness-to-pay threshold low cost. There are, however, discrepancies results among studies countries, could be cost parameters assumptions used models. As neoplasms such polypectomy, endoscopic mucosal resection, submucosal dissection, based on risk advanced histology deep invasion image-enhanced endoscopy least expensive avoid more recurrences. Furthermore, cost-effective. This article provides comprehensive literatures