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Session: ePoster: Colon and Colorectal Cancer 16 (Mon115)

EP773 - An Economic Forecasting Model to Quantify the Burden of Adverse Events Associated with Colonoscopy in the United States (US).

Monday, May 12, 2025
1:20 PM – 1:25 PM PT

    ePoster Presenter(s)

  • Deborah S. Keller, MS MD (she/her/hers)

    Associate Professor
    University of Strasbourg;
    Lankenau Medical Center and Lankenau Institute for Medical Research
    Cherry Hill, NJ, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • FO

    Francis O Neill, PhD

    Health Economist
    Compass Medical Inc
    Belfast, Dublin, Ireland

    Disclosure information not submitted.

    • Senior Author(s)

  • SP

    Silvana Perretta, MD PhD

    Professor
    Institute of Image-Guided Surgery (IHU-Strasbourg), Nouvel Hôpital Civil (NHC), University of Strasbourg
    Strasbourg, Alsace, France

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Deborah S. Keller, MS MD: This individual has no financial relationships with ineligible companies.
Silvana Perretta, MD PhD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Colonoscopy is the gold standard for screening benign and malignant colorectal diseases, and improved awareness and access have led to greater demand for screening and surveillance colonoscopy. However, recent reports highlight concerns on the quality and competency of colonoscopy training, which could contribute to higher rates of costs and complications during colonoscopy. Thus, study to on these colonoscopy outcomes is warranted. goal of this work was to develop a model assessing the burden of adverse events associated with colonoscopy in the United States.

Methods/Interventions: A decision-analytic model with a one-year time horizon was developed to estimate the clinical and economic consequences of colonoscopy procedures in adults. Clinical and cost inputs for the model were sourced from a literature review, key opinion leader input, and review of claims databases. The model incorporated data on colonoscopy volume, missed adenoma detection rates, perforation rates, and associated costs. All settings and providers were included, and costs adjusted to 2024.

Results/Outcomes: Over a year period, 16.6 million colonoscopies were conducted in a provider setting mix of inpatient hospitals (60.4%), ambulatory surgery centers (31.8%) and physician offices (7.6%). The model estimated direct annual costs of $12.1 billion in additional unplanned costs following colonoscopy. Most of the cost ($11.9 billion) was attributable to repeat procedures following missed adenomas. The rate of perforation was 0.08% at a cost $280 million dollars annually. The missed adenoma rate of 26% was the largest driver of the model results in sensitivity analysis.

Conclusion/Discussion: This cost-consequence analysis highlights the significant burden of colonoscopy in the United States healthcare system. The results could inform future teaching and training paradigms, as well as work to improve procedure quality, reduce complications, and optimize resource utilization.