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We evaluated whether age-and gender-based colorectal cancer screening is cost-effective. Recent studies in the United States identified age and gender as 2 important variables predicting advanced proximal neoplasia, and that women aged< 60 to 70 years were more suited for sigmoidoscopy screening due to their low risk of proximal neoplasia. Yet, quantitative assessment of the incremental benefits, risks, and cost remains to be performed.

Primary care screening practice (2008–2015). A Markov modeling was constructed using data from a screening cohort. The following strategies were compared according to the Incremental Cost Effectiveness Ratio (ICER) for 1 life-year saved: flexible sigmoidoscopy (FS) 5 yearly; colonoscopy 10 yearly; FS for each woman at 50-and 55-year old followed by colonoscopy at 60-and 70-year old; FS for each woman at 50-, 55-, 60-, and 65-year old followed by colonoscopy at 70 …