ObjectiveThe national population-based colorectal cancer screening programme in Hungary
was initiated in December 2018. We aimed to evaluate the current programme and investigate
the costs and benefits of potential future changes to overcome the low coverage of
the target population.MethodsWe performed an economic evaluation from a healthcare
payer perspective using an established micro-simulation model (Microsimulation Screening
Analysis-Colon). We simulated costs and benefits of screening with fecal immunochemical
test in the Hungarian population aged 50?100, investigating also the impact of potential
future scenarios which were assumed to increase invitation coverage: improvement of
the IT platform currently used by GPs or distributing the tests through pharmacies
instead of GPs.ResultsThe model predicted that the current screening programme could
lead to 6.2% colorectal cancer mortality reduction between 2018 and 2050 compared
to no screening. Even higher reductions, up to 16.6%, were estimated when tests were
distributed through pharmacies and higher coverage was assumed. This change in the
programme was estimated to require up to 26 million performed fecal immunochemical
tests and 1 million colonoscopies for the simulated period. These future scenarios
have acceptable cost-benefit ratios of ?8000??8700 per life-years gained depending
on the assumed adherence of invited individuals.ConclusionsWith its limitations, the
current colorectal cancer screening programme in Hungary will have a modest impact
on colorectal cancer mortality. Significant improvements in mortality reduction could
be made at acceptable costs, if the tests were to be distributed by pharmacies allowing
the entire target population to be invited.
