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Colorectal cancer screening policy in Hungary

Published online by Cambridge University Press:  06 January 2009

László Gulácsi ,
Gábor Vas ,
István Pintér  and
Ildikó Kriszbacher
László Gulácsi
Affiliation:
Associate Professor, Department of Public Administration, Director, Health Economics and Technology Assessment Research Centre, Corvinus University of Budapest, Fővám tér 8. 1093 Budapest, Hungary (laszlo.gulacsi@uni-corvinus.hu)
Gábor Vas
Affiliation:
PhD student, Department of Health-Economics, Policy & Management, University of Pécs, Vörösmarty u. 4., Pécs 7621 Hungary
István Pintér
Affiliation:
Assistant Professor, 2nd Department of Medicine, University of Pécs, Ifjúság u. 13., Pécs 7624 Hungary
Ildikó Kriszbacher
Affiliation:
Associate Professor, Institute of Nursing and Clinical Sciences, University of Pécs, Vörösmarty u. 4., Pécs 7621 Hungary
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Extract

We read with great interest the excellent paper of Gutiérrez-Ibarluzea et al. on the review of current policies of screening for colorectal cancer in European countries (12).Colorectal cancer screening has been a hot topic in health technology assessment and medical decision making (13;15;18). The study by Gutiérrez-Ibarluzea and colleagues focused mainly on the “old” fifteen member states of the European Union; however, colorectal cancer represents a large epidemiological (3;11) and economic (4) burden for the society and the healthcare financing agency in Eastern European countries. We would like to highlight some important aspect of colorectal cancer screening in Hungary.

Information

Type
Commentaries, Views, and Developments in Hta
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 1 , January 2009 , pp. 109 - 110
Copyright
Copyright © Cambridge University Press 2009

To the Editor:

We read with great interest the excellent paper of Gutiérrez-Ibarluzea et al. on the review of current policies of screening for colorectal cancer in European countries (Reference Gutiérrez-Ibarluzea12).Colorectal cancer screening has been a hot topic in health technology assessment and medical decision making (Reference Khandker, Dulski and Kilpatrick13;Reference Lejeune, Arveux, Dancourt, Béjean, Bonithon-Kopp and Faivre15;Reference Villeneuve and Coombs18). The study by Gutiérrez-Ibarluzea and colleagues focused mainly on the “old” fifteen member states of the European Union; however, colorectal cancer represents a large epidemiological (Reference Boncz and Sebestyen3;Reference Döbrőssy11) and economic (Reference Boncz, Sebestyén and Dávid4) burden for the society and the healthcare financing agency in Eastern European countries. We would like to highlight some important aspect of colorectal cancer screening in Hungary.

The Hungarian researchers Ottó and Németh have developed an immunochemical technique suitable for simultaneous demonstration of two blood proteins (hemoglobin and albumin) in the fecal sample (Reference Ottó and Németh17). Their method was successfully applied in pilot population-screening projects for early detection of colorectal cancer in Hungary (Budapest and Ajka). The projects were carried out in 1997–98 in Budapest with support from the World Bank “Close the gap” public health program (Reference Ottó and Döbrőssy16) and in the town Ajka and surroundings in 2003–04 (Reference Csonka, Molnár, Németh and Ottó10), respectively. It means that Hungary became a pioneer in the practical application of two-tier approach (having both a guaiac-based fecal occult blood test [FOBT] and an immunochemical test). The Hungarian Colorectal Cancer Screening Programme originally covered people ages 45–65 years which was modified to 50–70 years. The screening interval is 2 years. People in the target age group are invited by a personal invitation letter. Cost of screening are entirely reimbursed by The National Health Insurance Fund Administration (Országos Egészségbiztosítási Pénztár, OEP), the only healthcare financing agency in Hungary (Reference Boncz, Sebestyen, Dobrossy and Otto5).

The National Health Insurance Fund Administration (OEP) conducted a cost-effectiveness analysis to assess the economic nature of colorectal screening (Reference Boncz, Sebestyén and Dózsa7;Reference Boncz, Sebestyen and Pinter9) in the Hungarian setting. The simultaneous application of both the guaiac-based test and the immunochemical FOBT detecting hemoglobin and albumin was compared with no screening strategy. The cost of 1 life-year saved varied between $1,074 USD and $4,381 USD, which was acceptable for the National Health Insurance Fund Administration (OEP).

Finally, we would like to report that nationwide, population-based, organized screening programs for breast (Reference Boncz1;Reference Boncz, Sebestyen and Dobrossy6) and cervical (Reference Boncz2;Reference Boncz, Sebestyen and Ember8;Reference Kovács, Döbrőssy, Budai, Boncz and Cornides14) cancer was introduced in Hungary in 2002 and 2003, respectively, to reduce the high cancer mortality. After careful evaluation of the pilot programs, there is a heavy debate on the introduction of a nationwide screening program for colorectal cancer in Hungary. We hope that the introduction of a well-established screening program for colorectal cancer can reduce the high colorectal cancer mortality in Hungary.

References

REFERENCES

1. Boncz, I. Organized nationwide breast cancer screening programme was introduced in Hungary in 2002. Swiss Med Wkly. 2006;136:328.Google ScholarPubMed
2. Boncz, I. Prevention of cervical cancer screening in low-resource settings. JAMA. 2006;295:1248.CrossRefGoogle ScholarPubMed
3. Boncz, I, Sebestyen, A. Economy and mortality in Eastern and Western Europe between 1945–1990: The largest medical trial of history. Int J Epidemiol. 2006;35:796–797.CrossRefGoogle Scholar
4. Boncz, I, Sebestyén, A, Dávid, T. Comparative analysis of drug cost of breast, cervical and colorectal cancer in Hungary. Value Health. 2005;8:A42.CrossRefGoogle Scholar
5. Boncz, I, Sebestyen, A, Dobrossy, L, Otto, S. The role of immunochemical testing for colorectal cancer. Lancet Oncol. 2006;7:363–364.CrossRefGoogle ScholarPubMed
6. Boncz, I, Sebestyen, A, Dobrossy, L, et al. The organization and results of first screening round of the Hungarian nationwide organised breast cancer screening programme. Ann Oncol. 2007;18:795–799.CrossRefGoogle ScholarPubMed
7. Boncz, I, Sebestyén, A, Dózsa, C, et al. Health economics analysis of colorectal screening. [In Hungarian: A colorectalis szűrések egészség-gazdaságtani elemzése] Magy Onkol. 2004;48:111–115.Google ScholarPubMed
8. Boncz, I, Sebestyen, A, Ember, I. Organized, nationwide cervical cancer screening programme in Hungary. Gynecol Oncol. 2007;106:272–273.CrossRefGoogle ScholarPubMed
9. Boncz, I, Sebestyen, A, Pinter, I, et al. Age-group specific gap between treatment cost of and mortality due to breast and colorectal cancer. J Clin Oncol. 2007;25:4501–4502.CrossRefGoogle ScholarPubMed
10. Csonka, C, Molnár, C, Németh, M, Ottó, S. Results of and experiences with colorectal screening in town Ajka [In Hungarian: Az ajkai vastagbélszűrés eredményei és tapasztalatai] Magy Onkol. 2004;48:29.Google Scholar
11. Döbrőssy, L. Cancer mortality in central-eastern Europe: Facts behind the figures. Lancet Oncol. 2002;3:374–81.CrossRefGoogle ScholarPubMed
12. Gutiérrez-Ibarluzea, I, Asua J, Latorre K. Policies of screening for colorectal cancer in European countries. Int J Technol Assess Health Care. 2008;24:270–276.CrossRefGoogle ScholarPubMed
13. Khandker, RK, Dulski, JD, Kilpatrick, JB, et al. A decision model and cost-effectiveness analysis of colorectal cancer screening and surveillance guidelines for average-risk adults. Int J Technol Assess Health Care. 2000;16:799–810.CrossRefGoogle ScholarPubMed
14. Kovács, A, Döbrőssy, L, Budai, A, Boncz, I, Cornides, Á. Cervical screening in Hungary: Why does the “English model” work but the “Hungarian model” does not? Eur J Gynaecol Oncol. 2008;29:5–9.Google ScholarPubMed
15. Lejeune, C, Arveux, P, Dancourt, V, Béjean, S, Bonithon-Kopp, C, Faivre, J. Cost-effectiveness analysis of fecal occult blood screening for colorectal cancer. Int J Technol Assess Health Care. 2004;20:434–439.CrossRefGoogle ScholarPubMed
16. Ottó, S, Döbrőssy, L. Screening for colorectal cancer with immunological FOBT. Br J Cancer. 2004;90:1871–1872.CrossRefGoogle ScholarPubMed
17. Ottó, S, Németh, M. Double immunochemical screening test (hemoglobin and albumin) for the detection of occult intestinal bleeding. J Clin Lab Anal. 1993;7:301–306.CrossRefGoogle ScholarPubMed
18. Villeneuve, PJ, Coombs, A. Screening for colorectal cancer using the fecal occult blood test: An actuarial assessment of the impact of a population-based screening program in Canada. Int J Technol Assess Health Care. 2003;1:715–23.CrossRefGoogle Scholar