We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
MedicalSystem

Download Mobile App




Events

ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.

Fecal Immunochemical Test a Less Expensive Alternative for Colorectal Cancer Screening

By LabMedica International staff writers
Posted on 18 Oct 2022
Print article
Image: FIT has been found to detect early-stage cancer at one-fifth the cost (Photo courtesy of Allegheny Health)
Image: FIT has been found to detect early-stage cancer at one-fifth the cost (Photo courtesy of Allegheny Health)

Guidelines issued by the U.S. Preventive Services Task Force (USPSTF) suggest a fecal immunochemical test (FIT) can be used as the primary noninvasive screening modality for early-stage colorectal cancer, although a significant proportion of patients still receive a more expensive alternative test called Cologuard. Commercially available noninvasive screening tests for colorectal cancer - a FIT and the multi-target stool DNA test (mt-sDNA; or Cologuard) - are equally effective for screening patients with early-stage colorectal cancer. Data used for national screening guidelines has shown no difference between the two tests at detecting adenoma versus colorectal malignancy. However, a new study has revealed that a FIT costs about one-fifth of the multi-target DNA test. These results align with previous studies out of Japan and the Netherlands examining FIT as an appropriate screening modality that is more cost effective than other types of noninvasive colorectal screening tests.

In the study, researchers at Allegheny Health Network (Pittsburgh, PA, USA) looked at 117,519 people in the Highmark claims database who underwent colorectal screening in 2019. Highmark is a Blue Cross Blue Shield Association insurer in four Mid-Atlantic states. From that group, the researchers identified 91,297 people who had noninvasive screening with either the fecal immunochemical test (FIT, n=45,487) or the DNA test (mt-sDNA, n=46,110) instead of having a routine colonoscopy. The findings revealed that among the study population that underwent colorectal screening, 45,487 (38.7%) had one of two commercially available FIT tests and 46,110 (39.2%) had the mt-sDNA test. Patients who were screened with either test presented with early disease, staged from 0 to II, at similar rates: 59.5% for FIT and 63.2% for mt-sDNA test (p=0.77).

Patients within the Allegheny Health Network Oncology Registry diagnosed with colorectal cancer were matched to their claims data to determine distribution of cancer stage. If the noninvasive test indicated signs of early disease, patients were then referred for additional testing to confirm the findings. The total annual costs for the tests were USD 6.47 million - USD 1.1 million for a FIT, or about USD 24 per test, and USD 5.6 million for mt-sDNA, or about USD 121 per test. Costs were calculated using Medicare reimbursement rates. The researchers determined that transitioning all noninvasive colorectal cancer screening to FIT would result in a USD 3.9 million savings annually in the study population. What makes this study unique is the methodology used to analyze the claims data. The researchers analyzed outcomes in the local health registry and then applied those outcomes to the claims database. The cost of a screening colonoscopy in the database the researchers used was USD 635.

"Despite national guidelines suggesting that FIT be used as the primary noninvasive screening modality, we found that on review of our insurer's claims data, a significant proportion of patients still receive a more expensive alternative test. There is substantial cost savings not only to our patients but to our health system with promoting appropriate use of noninvasive testing," said Pavan K. Rao, MD, a general surgery resident at Allegheny Health Network. "There was no difference in the clinical stage at the time of diagnosis between the two tests, which again demonstrates the clinical equipoise maintained by switching to FIT."

"It's not just the cost of the mt-sDNA test kit or the cost of the FIT kit multiplied by the number of members in the healthcare system," said study coauthor Casey J. Allen, MD, a surgical oncologist at Allegheny Health Network. "It's the full downstream costs depending on the rates of false-positive and false-negative tests and how much it costs to obtain a colonoscopy when that occurs."

Related Links:
Allegheny Health Network 

Gold Supplier
Vaginosis Test
VAGINAL PANEL REALTIME PCR KIT
New
4K Lite Ultra HD Camera
UHD-4K Lite Camera
New
Plastic Jerricans
Diamond RealSeal Jerricans
New
Auto Liquid Handling & Homogenizer Workstation
LH 96

Print article
SUGENTECH INC.

Channels

Clinical Chem.

view channel
Image: Equivalence of Genetically Elevated LDL and Lipoprotein(a) on Myocardial Infarction (Photo courtesy of Viborg Regional Hospital)

Familial Hypercholesterolemia Patients With ACD Have Elevated Lipoprotein(a)

Familial hypercholesterolemia (FH) is a genetic disorder characterized by high cholesterol levels, specifically very high levels of low-density lipoprotein (LDL cholesterol), in the blood and early cardiovascular... Read more

Microbiology

view channel
Image: Ring-form trophozoites of Plasmodium vivax in a thin blood smear (Photo courtesy of Centers for Disease Control and Prevention)

Immune Regulators Predict Severity of Plasmodium vivax Malaria

Cytokines and chemokines are immune response molecules that display diverse functions, such as inflammation and immune regulation. In Plasmodium vivax infections, the uncontrolled production of these molecules... Read more

Pathology

view channel
Image: Breast cancer spread uncovered by new molecular microscopy (Photo courtesy of Wellcome Sanger Institute)

New Molecular Microscopy Tool Uncovers Breast Cancer Spread

Breast cancer commonly starts when cells start to grow uncontrollably, often due to mutations in the cells. Overtime the tumor becomes a patchwork of cells, called cancer clones, each with different mutations.... Read more

Industry

view channel
Image: With Cell IDx’s acquisition, Leica Biosystems will be moving its multiplexing menu forward (Photo courtesy of Leica Biosystems)

Leica Biosystems Acquires Cell IDx, Expanding Offerings in Multiplexed Tissue Profiling

Leica Biosystems, a technology leader in automated staining and brightfield and fluorescent imaging (Nussloch, Germany), has acquired Cell IDx, Inc. (San Diego, CA, USA), which provides multiplex staining... Read more
Copyright © 2000-2022 Globetech Media. All rights reserved.