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    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Pence, Barbara C. Belasco, Eric J. and Lyford, Conrad P. 2012. Prevention of Colorectal Cancer by Aspirin and/or Calcium: Efficacy, Mechanisms, and Cost Effectiveness. Current Colorectal Cancer Reports, Vol. 8, Issue. 1, p. 51.


    Saini, Sameer D. Schoenfeld, Philip and Vijan, Sandeep 2010. Surveillance Colonoscopy Is Cost-Effective for Patients With Adenomas Who Are at High Risk of Colorectal Cancer. Gastroenterology, Vol. 138, Issue. 7, p. 2292.


    Omidvari, Amir-Houshang Meester, Reinier G.S. and Lansdorp-Vogelaar, Iris 2016. Cost Effectiveness of Surveillance in GI practice. Best Practice & Research Clinical Gastroenterology,


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  • International Journal of Technology Assessment in Health Care, Volume 25, Issue 2
  • April 2009, pp. 222-231

Can calcium chemoprevention of adenoma recurrence substitute or serve as an adjunct for colonoscopic surveillance?

  • Aasma Shaukat (a1), Murtaza Parekh (a2), Joseph Lipscomb (a3) and Uri Ladabaum (a2)
  • DOI: http://dx.doi.org/10.1017/S026646230909028X
  • Published online: 01 April 2009
Abstract

Objectives: The aim of this study was to examine the potential cost-effectiveness of calcium chemoprevention post-polypectomy as a substitute or adjunct for surveillance.

Methods: We constructed a Markov model of post-polypectomy adenoma recurrence and colorectal cancer (CRC) development, calibrated to data from prospective chemoprevention trials of fiber, calcium, antioxidants, and aspirin. We modeled four scenarios for 50-year-old patients immediately after polypectomy: (i) natural history with no further intervention; (ii) elemental calcium 1,200 mg/day from age 50–80; (iii) surveillance colonoscopy from age 50–80 every 5 years, or 3 years for large adenoma; (iv) calcium + surveillance. Patients were followed up until age 100 or death.

Results: Calcium was cost-effective compared to natural history ($49,900/life-year gained). However, surveillance was significantly more effective than calcium (18.729 versus 18.654 life-years/patient; 76 percent versus 14 percent reduction in CRC incidence) at an incremental cost of $15,900/life-year gained. Calcium + surveillance yielded a very small benefit (0.0003 incremental life-years/patient) compared with surveillance alone, at a substantial incremental cost of $3,090,000/life-year gained.

Conclusion: Post-polypectomy calcium chemoprevention is unlikely to be a reasonable substitute for surveillance. It may be cost-effective in patients unwilling or unable to undergo surveillance.

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International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
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