Cost-Effectiveness Analysis of Screening for Colorectal Cancer in Japan

Ichiro Tsuji, Akira Fukao, Shigeru Hisamichi, Tadami Shoji, Ichiro Kuwajima, Nobuyuki Sugawara

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


To clarify the best cost-effective screening strategy for colorectal cancer in Japan, the cost-effectiveness ratio was compared among six currently performed procedures. The analysis was made using a simulation model to estimate long-term cost and effectiveness of the screening programs. In the screening by the immunological fecal occult blood test (FOBT), a comparison between the one- and two-day fecal collection methods indicated that the latter was more cost-effective than the former. A comparison was also made on the four workup methods: barium enema (BE) alone, a combination of BE and sigmoidoscopy (BE+SIG), total colonoscopy (TCF) alone, and a combination of BE and TCF (BE+TCF). The cost-effectiveness ratio was the lowest in the method using TCF alone, followed by those based on BE alone and BE+TCF, and the highest in the BE+SIG method. The superiority of TCF alone strategy was stable over a range of estimates such as the sensitivity of diagnostic tests, the probability of complications due to TCF, etc. It is concluded that a combination of the two-day FOBT and TCF yields the best cost-effectiveness.

Original languageEnglish
Pages (from-to)269-278
Number of pages10
JournalTohoku Journal of Experimental Medicine
Issue number4
Publication statusPublished - 1991


  • colorectal cancer screening
  • cost-effectiveness analysis
  • simulation study

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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