Colorectal cancer (CRC) remains a significant public health burden. Unfortunately, many patients avoid traditional screening methods such as colonoscopy or stool-based tests. Blood-based CRC screening offers a non-invasive alternative that could improve population health outcomes. By providing a simpler testing modality, healthcare providers can reach individuals who previously declined all screening options. Consequently, this approach may significantly reduce cancer-related mortality in the long term.

This study utilized a validated discrete-event simulation model to assess 10,000 individuals starting at age 45. Researchers analyzed clinical outcomes and cost-effectiveness from a healthcare sector perspective. Evidence from randomized controlled trials informed patient preferences for various screening options. Furthermore, the researchers modeled adherence using both ideal and longitudinal real-world scenarios. The findings indicate that adding blood tests to the screening arsenal yields substantial benefits. Specifically, CRC deaths averted increased between 68% and 247% in revealed preference scenarios compared to no screening.

Benefits of Blood-based CRC Screening for Adherence

Cost-effectiveness remains a critical factor for implementing any new medical technology. The analysis found that blood tests fall well within the standard willingness-to-pay threshold of $100,000 per quality-adjusted life-year (QALY). Incremental cost-effectiveness ratios (ICERs) ranged from $30,464 to $85,497 across different scenarios. Therefore, these tests provide high value while addressing the screening gap. Additionally, the non-invasive nature of the test helps patients overcome common psychological and logistical barriers associated with colonoscopy.

Despite these promising results, some limitations exist. The study relied on informed assumptions for natural history and longitudinal adherence due to limited real-world data. However, the simulation demonstrates that blood-based CRC screening can lead to cost-effective increases in life-saving outcomes. Healthcare systems should consider these findings when developing inclusive screening programs for resistant populations.

Frequently Asked Questions

Is blood-based CRC screening a replacement for colonoscopy?

No, it serves as an alternative for patients who decline traditional methods, helping to increase overall screening rates and catch cancer earlier.

What makes blood tests cost-effective in this study?

Blood tests are cost-effective because they significantly increase screening participation among individuals who otherwise would not be screened at all, reducing long-term treatment costs.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice or a professional recommendation. Refer to the latest local and national guidelines for clinical practice.

References

1. Forbes SP et al. Impact of offering blood-based testing alongside existing modalities for colorectal cancer screening among those who previously declined screening: an economic evaluation. J Med Econ. 2026 Dec undefined. doi: 10.1080/13696998.2026.2633027. PMID: 41764032.


2. Yay Donderici E et al. Cost-effectiveness of blood-based colorectal cancer screening - a simulation model incorporating real-world longitudinal adherence. Expert Rev Pharmacoecon Outcomes Res. 2025 Jun;25(5):671-677.


3. van den Puttelaar R et al. Cost-effectiveness of a hypothetical blood-based test for colorectal cancer screening. Gastroenterology. 2024;166(4):S-102.