TABLE 2.

Average Unit Costs of Colorectal Cancer Screening Demonstration Program (CRCSDP) Clinical Tests and Related Services and Distribution of Costs Associated With Fecal Occult Blood Test Screening and With Colonoscopy Screening at Each CRCSDP Site^a

Cost Variable	Baltimore City	St. Louis	Nebraska	Suffolk County, NY	Greater Seattle
Screening cost per test, $
Screening FOBT: Kit	—	—b	3	—	7
Screening FOBT: Processing	—	—	12	—	—
Screening FOBT: Patient coordinationc	—	—	—	—	9
Office visit: FOBT	—	—	—	—	58
Screening colonoscopy	1477	610	835	989	728
Office visit: Colonoscopy	64	21	93	-	123
Follow-up colonoscopy cost per test, $
Clearance colonoscopyd	1485	—	—	1562	—
Diagnostic colonoscopy	—	—	890	—	794
Surveillance colonoscopy	1491	704	815	1054	855
Average clinical cost per individual, $e
FOBT screening	—	—b	49	—	148
Colonoscopy screening	1600	654	842	1030	874
Distribution of screening costs, %f
FOBT screening costs
Screening test	—	—b	6	—	5
Test processing	—	—	25	—	—
Patient coordination	—	—	—	—	6
Office visit	—	—	—	—	19
Diagnosis	—	—	63	—	68
Initial surveillance colonoscopy	—	—	6	—	3
Colonoscopy screening costs, %
Screening test	92	93	99	96	83
Repeat (after incomplete screen)	1	6	0.6	0.4	0.3
Office visit	3	0.6	0.2	—	16
Clearance (after complete screen)	3	—	—	3	—
Initial surveillance colonoscopy	0.7	0.2	—	0.7	—

Abbreviations: CRC, colorectal cancer; FOBT. fecal occult blood test.

^aListed are the average clinical costs for CRC screening, diagnosis, and initial surveillance services provided to average-risk program participants during 2006 to 2009 for whom complete cost data were reported (for patient counts, see Table 1).

^bData were suppressed because of the small sample size.

^cGreater Seattle reimbursed providers for a patient coordination fee at a rate of $15 for many patients who underwent screening with FOBT. The average cost based on all patients screened by FOBT is presented here.

^dA second colonoscopy was required after a complete screening colonoscopy to investigate findings or to complete polyp removal. A higher overall cost may result from higher pathology costs because of extensive polyp removal.

^eThese include the costs incurred by a small number of patients who followed an atypical screening cascade. These costs represent approximately 0.3% of the total costs.

^fThe share of total clinical costs for each component of a screening program is indicated, including screening, repeat, and follow-up tests and associated office visits. Totals may not sum to 100% because of rounding error.