RESUMO
INTRODUCTION: Colorectal cancer (CRC) is a serious health problem, and various screening programs to reduce CRC have been introduced worldwide. However, the costeffectiveness of a program based on onceinalifetime colonoscopy in Poland is unknown. OBJECTIVES: The main aim of this study was to assess the costeffectiveness of Polish Colonoscopy Screening Platform (PCSP), the colonoscopy screening program in Poland. PATIENTS AND METHODS: A Markov model was constructed to compare the strategy of colonoscopy screening as compared with no screening in 100 000 subjects. The model was based on data collected from the nationwide Polish CRC screening program whenever possible. The incremental costeffectiveness ratio (ICER) was calculated and compared with the willingnesstopay thresholds. A sensitivity analysis was also performed using the Monte Carlo simulation. RESULTS: Colonoscopy screening within PCSP resulted in a 18.9% reduction in CRC incidence and 19.8% reduction in CRC mortality. The strategy allowed a gain of 2317 lifeyears saved (1959 after discount ing). The cost of colonoscopy screening per participant examined was estimated at 267.70 USD (95% CI, 263.08-272.32 USD). The ICER was less than 6500 USD, which was much lower than the accepted willingnesstopay thresholds, indicating that the screening was costeffective. CONCLUSIONS: Colonoscopy screening within the PCSP is costeffective and may have a substantial impact on the Polish society due to lifeyears saved. The results have good informative value not only for health policy makers and medical practitioners, but also for health technology assessment.