Great analysis. Even in the best case scenario and ARR (absolute risk reduction) is 0.3%, this would put NNT (number needed to treat) at 333 colonoscopies per year to save 1 patient from dying at the end of 10 years. If colonoscopy cost is $3000, this would equates to spending $1,000,000 (=333 x $3000) to save 1 person from dying from …
Great analysis. Even in the best case scenario and ARR (absolute risk reduction) is 0.3%, this would put NNT (number needed to treat) at 333 colonoscopies per year to save 1 patient from dying at the end of 10 years. If colonoscopy cost is $3000, this would equates to spending $1,000,000 (=333 x $3000) to save 1 person from dying from colon cancer every 10 years. If we interpolate, this means spending $10,000,000 to save 1 person from dying from colon cancer each year through widespread colonoscopy screening. So does colonoscopy screening save lives? YES, but at what cost!!! Colonoscopy is NOT a screening test, it's a diagnostic test. Screening test should be cheap, easy, and ideally with a decent sensitivity (can accept lower specificity). For example, d-dimer is a good screening test for PE/ DVT, while chest CTA and Doppler US are good diagnostic tests. Bottom line: colonoscopy is not a realistic screening test. Agree that we need a good RCT on FIT which is setup as a much better screening test (cheaper and easier to do).
Great analysis. Even in the best case scenario and ARR (absolute risk reduction) is 0.3%, this would put NNT (number needed to treat) at 333 colonoscopies per year to save 1 patient from dying at the end of 10 years. If colonoscopy cost is $3000, this would equates to spending $1,000,000 (=333 x $3000) to save 1 person from dying from colon cancer every 10 years. If we interpolate, this means spending $10,000,000 to save 1 person from dying from colon cancer each year through widespread colonoscopy screening. So does colonoscopy screening save lives? YES, but at what cost!!! Colonoscopy is NOT a screening test, it's a diagnostic test. Screening test should be cheap, easy, and ideally with a decent sensitivity (can accept lower specificity). For example, d-dimer is a good screening test for PE/ DVT, while chest CTA and Doppler US are good diagnostic tests. Bottom line: colonoscopy is not a realistic screening test. Agree that we need a good RCT on FIT which is setup as a much better screening test (cheaper and easier to do).