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Gastroenterology Research and Practice
Volume 2012, Article ID 728454, 4 pages
Clinical Study

Cost-Effectiveness of Total Colonoscopy in Screening of Colorectal Cancer in Japan

1Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
2Cancer Screening Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan
3Department of Medical Statistics, Shiga University of Medical Science, Shiga 520-2192, Japan

Received 22 September 2011; Accepted 13 October 2011

Academic Editor: Cesare Hassan

Copyright © 2012 Masau Sekiguchi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. In Japan, the cost-effectiveness of total colonoscopy (TCS) for primary screening of colorectal cancer (CRC) is unclear. We compared the cost of identifying a patient with CRC using two primary screening strategies: TCS (strategy 1) and the immunochemical fecal test (FIT) (strategy 2). Materials and Methods. We retrospectively analyzed the TCS screening database at our institution from February 2004 to August 2010 (strategy 1, 𝑛 = 1 5 , 3 4 8 ) and the Japanese nationwide survey of CRC screening in 2008 (strategy 2, 𝑛 = 5 , 2 6 7 , 4 4 3 ). Results. 112 and 6,838 CRC cases were detected in strategies 1 and 2, costing 2,124,000 JPY and 1,629,000 JPY, respectively. The rate of earlier-stage CRC was higher in strategy 1. Conclusions. The cost was higher using TCS as a primary screening procedure. However, the difference was not excessive, and considering the increased rate of detecting earlier CRC, the use of TCS as a primary screening tool may be cost-effective.