Colorectal cancer (CRC) remains one of the most pressing health challenges globally, ranking as the second leading cause of cancer-related mortality. Within the Gulf nation of Kuwait, it stands as the second most common type of cancer, with the Kuwait Cancer Registry reporting approximately 2,710 cases between 2010 and 2019. Despite this significant burden, the nation faces obstacles related to the underutilization of screening programs for early detection.
A recent study published on March 3, 2025, aimed to evaluate the cost-effectiveness of three prevalent colorectal cancer screening strategies: the Fecal Occult Blood Test (FOBT) followed by either colonoscopy or sigmoidoscopy, colonoscopy alone, and sigmoidoscopy alone. This study highlights the need for effective screening policies, particularly as only 19% of eligible Kuwaiti nationals have participated in cancer screening initiatives.
Utilizing a Decision Tree Analysis Model, researchers assessed the costs and outcomes of these screening modalities over ten years post-diagnosis. This model was comprehensive, taking the perspective of Kuwait’s healthcare providers to inform cost-effectiveness analyses accurately. The findings revealed noteworthy differences among the screening strategies.
The results indicated the screening method involving FOBT followed by either colonoscopy or sigmoidoscopy yielded the best health outcomes, providing 7.7 Quality-Adjusted Life Years (QALYs) at the cost of approximately USD 3,573. This approach was significantly more effective and less costly than not screening at all, which resulted in 7.2 QALYs at USD 4,084. Screening solely with sigmoidoscopy or colonoscopy produced 6.8 QALYs each but came at higher costs, USD 4,905 and USD 5,002 respectively.
“FOBT followed by colonoscopy or sigmoidoscopy resulted in 7.7 quality-adjusted life years (QALYs) at a cost of USD 3,573,” stated the authors of the article. This reveals the effectiveness of the FOBT approach not only in clinical outcomes but also from the economic perspective, as it effectively utilizes healthcare resources to achieve maximum benefits for patients.
The analysis drew upon data extending from 2010 to 2019, comparing these screening strategies, and included sensitivity analyses to assess the robustness of the findings. This systematic approach allows significant uncertainty surrounding costs and outcomes to be explored, ensuring policymakers have sound data to assist decision-making.
Interestingly, the study emphasizes the cost-effectiveness of FOBT, highlighting the economic trade-offs associated with the more invasive techniques of sigmoidoscopy and colonoscopy. “These negative ICER values demonstrate the dominance of the FOBT with colonoscopy or sigmoidoscopy strategy over other screening approaches,” the authors noted, underscoring the need to adopt these methods at the national level.
The economic evaluations align with international standards which endorse promoting less invasive and less costly screening techniques without compromising healthcare quality. The search for efficient screening strategies must not only aim for clinical effectiveness but must also prioritize the allocation of limited healthcare resources, especially within developing healthcare systems.
Policymakers are urged to prioritize initiatives fostering awareness of colorectal cancer screening benefits among the population. Greater emphasis on campaigns promoting FOBT will be pivotal not only for improving screening rates but also to engage the public effectively and encourage early detection of cancer, thereby lowering related mortality rates.
Integratively, data suggests implementing routine FOBT-based screening could facilitate massive reductions in CRC incidence and mortality within Kuwait, aligning healthcare practices with those globally recognized as best practice. The recommended adoption of FOBT combined with follow-up colonoscopy or sigmoidoscopy is poised to optimize both health outcomes and effective use of healthcare expenditures.
With these results, it’s clear the Kuwaiti healthcare system stands to benefit significantly from the inclusion of cost-effective screening strategies. By adopting the recommendations from this study, Kuwait can advance its public health agenda, ensuring effective screening is not just aspirational but achievable.
This research lays the groundwork for future studies confirming the practical application of these findings. The hope remains this will lead to the establishment of comprehensive screening programs catered to the Kuwaiti population—elevated healthcare accessibility and efficacy awaits.