Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 21, 2024
Date Accepted: Apr 28, 2025
The cost-effectiveness of Artificial Intelligence-assisted Colonoscopy as a primary or secondary screening test in population-based colorectal cancer screening programme: a Markov modelling study
ABSTRACT
Background:
The study provided the cost-effectiveness of using AI colonoscopy in different population-based CRC screening strategies.
Objective:
The study aimed to provide insights into the potential benefits and economic implications of incorporating AI colonoscopy into CRC screening programs.
Methods:
To evaluate the cost-effectiveness of different population-based colorectal cancer (CRC) screening strategies, including the use of Artificial Intelligence (AI)-aided colonoscopy, by comparing incremental cost-effectiveness ratios (ICERs) and various outcome measures such as loss of cancer-related life-years, prevention of CRC cases, life-years saved, and total cost per life-year saved. Data from international literature and the government gazette were accessed to calculate relevant cost and performance estimates.
Results:
The incremental cost-effectiveness ratio (ICER) of [FIT + colonoscopy], [FIT + AI colonoscopy]; colonoscopy; and AI colonoscopy was US$138,539, US$122,539, US$203,929, and US$180,444, respectively. When compared with [FIT + colonoscopy], use of [FIT + AI colonoscopy] could lead to significantly smaller total loss of cancer-related life-years (5,355 vs. 5,327); higher number and proportion of CRC cases prevented (120 vs. 132, 3.7% vs. 4.1%), more life-years saved (280 vs. 308), and lower total cost per life-year saved (US$944,008 vs. US$854,367). [FIT + AI colonoscopy] had the lowest ICER [US$122,539] and dominated across all other strategies (-US36,462 vs. FIT + colonoscopy). When colonoscopy is adopted as a primary screening test, AI colonoscopy dominated conventional colonoscopy (ICER -39,040).
Conclusions:
These findings show that Faecal immunochemical tests (FIT) followed by AI colonoscopy is the most cost-effective strategy in population-based CRC screening programmes.
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