Rehydration of Guaiac-Based Faecal Occult Blood Tests in Mass Screening for Colorectal Cancer: An Economic Perspective

Abstract

Owing to dehydration during storage, faecal occult blood tests have been found to lose sensitivity; accordingly, test rehydration before development has been advocated, although this practice has yet to be subjected to an economic evaluation. In this paper, the results from two major screening trials in Sweden and England, one using rehydration and the other not, are so evaluated, based on a costing model developed within the English trial. The higher sensitivity resulting from rehydration was found to be accompanied by losses in specificity, such that, although more cancers are detected, the costs of screening and of cancer detection are actually considerably higher under the rehydration regimen than with non-hydration.

Key Words:

• Cancer
• colorectal cancer
• cost-effectiveness
• economic evaluation
• faecal occult blood test
• mass screening