Nonmedical costs of colorectal cancer screening using CT colonography

Abstract

Purpose: Nonmedical costs are important because they may influence screening uptake and the results of cost-effectiveness analyses of colorectal cancer (CRC) screening. Although the nonmedical costs of CRC screening are known for fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy, they are unknown for CT colonography (CTC). The purpose of this study was to determine the nonmedical costs of CTC.

Methods: Four hundred eighty-one consecutive individuals presenting for CRC screening using CTC were approached at a radiology clinic in Calgary, Alberta, Canada, to participate in the study. Of these, 197 agreed to have a questionnaire mailed to them. Subjects completed the questionnaire, including items on time off work, both for the subject and any accompanying caregiver; travel details; and direct out-of-pocket expenses. Time costs were valued at government of Canada wage rates. Travel costs included estimated costs for travel by car and actual parking costs and taxi and public transportation fares. Car user's costs were calculated using a Canadian Automobile Association estimate of motoring costs per kilometer. Costs are reported in 2010 Canadian dollars.

Results: One hundred thirty-two subjects returned the questionnaire (mean age, 57 years; 65% men; 67% employed). Ten subjects traveled >200 km for their CTC. The nonmedical costs (subject with or without caregiver) for the 122 subjects who resided within 200 km of the clinic averaged $101.

Conclusions: The nonmedical costs of CRC screening using CTC are significant but lower than those of colonoscopy. Patients should be aware of these differential costs, and they should be incorporated into economic analyses of CRC screening.