Table 1.

ICERs for Other Large, Randomized Interventions to Improve CRC Screening

First Author and Year	Total No. of Participants	Target Population	Target Cancer Screening	Intervention	Cost of Intervention(US$)	Baseline Screen Rate (%)	Change in Screening Rate (%)	ICER: Incremental Cost per Percent Increase in Screening(US$)
Gorin 2008 (manuscript submitted)*	1,290 patients; 264 physician practices	Primary care physician offices in 2 geographically distinct New York City communities	FOBT, flexible sigmoidoscopy, colonoscopy	Academic detailing intervention, consisting of face-to-face visits from a trained educator and self-learning packets reinforcing CRC screening guidelines	147,865	9-10 (Bronx, Northern Manhattan) 21-28 (Upper East and West sides, Murray Hill)	7 across both communities	21,124 (colonoscopy) FOBT and flexible sigmoidoscopy not clinically effective, so ICERs not calculated
Wolf 2005,11 Ferreira 20056*	1,978 patients; 113 provider groups	Primary care physicians within an urban Veterans Affairs Medical Center	FOBT, flexible sigmoidoscopy, colonoscopy	Provider-directed intervention with regular feedback sessions of patient screening rates	86,753	32	9	9,639
Lairson 2007,7 Pignone 200212	1,546 patients	Patients in a large urban, university-based family medicine practice, age 50-74 years and at average risk for CRC	FOBT, flexible sigmoidoscopy, colonoscopy	Patients randomized to 4 groups: Control group Standard intervention, consisting of mailed informational brochure and invitation letter Tailored intervention, consisting of standard intervention + tailored message based on survey data* Tailored intervention + reminder phone call by a trained health educator*	Control = 0 Standard intervention = 16,254 Tailored intervention = 57,900 Tailored intervention + phone call = 77,200	Control = 32 Standard intervention = 46	Standard intervention = 14 Tailored intervention = −2 Tailored intervention + phone call = 2 Note: Control group is the standard intervention group	Standard intervention = 1,161 Tailored intervention = not clinically effective compared with standard intervention, so ICER not calculated Tailored intervention + phone call = 38,600
Shankaran 2007,10 Denberg 20065	781 patients	Patients in university-based internal medicine clinics (majority with commercial or university insurance) who received referrals for screening colonoscopy	Colonoscopy	Customized mailed informational brochure	1,927	59	12	161
Roetzheim 2004,9 Chirikos 20044	1,237 patients	Patients enrolled in a county-funded health insurance plan in Florida (do not qualify for Medicaid or Medicare)	FOBT	“SOS Intervention”: cancer screening checklist performed by patients and color-coded chart reminders for physicians.	3,662	12	28	131

Abbreviations: ICER, incremental cost-effectiveness ratio; CRC, colorectal cancer; FOBT, fecal occult blood test.

^*Physician-directed interventions.