Aims
To estimate the cost of adopting computer-aided detection (CADe) in colonoscopy.
Methods
We conducted a microsimulation-based cost-effectiveness analysis with European individuals aged 60–69 undergoing either (i) screening colonoscopy or (ii) colonoscopy after a positive biennial faecal immunochemical test (FIT) without and with computer-aided polyp detection (CADe). The CADe device was capacity-constrained to 10,000 individuals per device total in a 10-year timeframe (1,000 individuals per year). The main outcome measure was cost of CADe per CRC prevented.
Results
In screening colonoscopy, each CADe device prevented 11 CRC cases. The additional cost per CRC prevented was $ 64,402, of which $ 2,888 (4.48 %) was attributable to the CADe purchase itself and $ 61,514 (95.52 %) from follow-up colonoscopies. In colonoscopy after a positive faecal immunochemical test (FIT) with CADe, each CADe device prevented 5 CRC cases. The additional cost per CRC prevented was $ 23,857, of which $ 6,353 (26.63 %) was attributable to the CADe purchase and $ 17,504 (73.37 %) from follow-up colonoscopies.
Conclusions
Adopting CADe in colonoscopy will have additional cost in screening colonoscopy than in FIT positive colonoscopy.