Unit costs in population-based colorectal cancer screening using CT colonography performed in university hospitals in The Netherlands.

OBJECTIVES: Computed tomography (CT) colonography cost assumptions so far ranged from 346 to 594 per procedure, based on clinical CT reimbursement rates. The aim of our study was to estimate the costs in a screening situation. METHODS: Data were collected within an invitational population-based CRC screening trial (n = 2,920, age 50-75 years) with a dedicated CT-screening setting. Unit costs were calculated per action, per invitee and per participant (depending on adherence) and per individual with detected advanced neoplasia. Sensitivity analyses were performed, and alternative scenarios were considered. RESULTS: Of the invitees, 47.2 % were reminded, 38.8 % scheduled for an intake, 37.2 % scheduled for CT colonography, 33.6 % underwent CT colonography and 1.1 % needed a re-examination. Lesions ≥ 10 mm were detected in 2.9 % of the invitees. Invitation costs were Euro 5.57. Costs per CT colonography (intake to results) were Euro 144.00. Extra costs of communication of positive results were Euro 9.00. Average costs of invitational-based CT colonography screening were Euro 56.97 per invitee, Euro 169.40 per participant and Euro 2,772.51 per individual with detected advanced neoplasia. CONCLUSIONS: Dutch costs of CT-screening were substantially lower than the cost assumptions that were used in published cost-effectiveness analyses on CT colonography screening. This finding indicates that previous cost-effectiveness analyses should be updated, at least for the Dutch situation.