A cost-effectiveness of Fecal DNA methylation test for colorectal cancer screening in Saudi Arabia

Background In the Saudi Arabia, we estimated the cost-effectiveness between fecal DNA methylation test (FDMT) and fecal immunochemical testing (FIT) to detect colorectal cancer (CRC) and precancerous lesions in the national screening program. Participants and methods A Markov model was used from 45 to 74 years old CRC screening to compare the cost-effectiveness with the FDMT vs FIT. We predicated the longitudinal participation patterns in the perfect adherence vs organized programs screening covered by national budgets. Outcomes incorporated the incidence rates and mortality rates, cost, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs) under the perfect adherence as well as incidence and mortality forecast within 3, 6 and 9 years. Results Under the perfect adherence, the total cost of FDMT was cheaper 38.16% than FIT and extends 0.22 QALYs per person. Furthermore, FDMT was more cost-effective as ICERs ($1487.30 vs $1982.42 per QALY saved) compared with FIT test. Therefore, FDMT test dominated than FIT every year (more costly and less effective). Compared with the organized FDMT programs (6.6% initial positive rate and 54% coloscopy compliance rate), the FIT program (5.8% initial positive rate and 48% coloscopy compliance rate) had 6.25 times to 7.76 times on the incidence rates; 5.12 times to 12.19 times on the mortality rates among 3, 6 and 9 years prediction. Conclusions Through the Markov model, we compared FDMT was less costly and more effective than the FIT test under the perfect and organized adherence within nine years prediction. It implied that FDMT might the novel cost-effective tool for Saudi Arabia national screening program.