Abstract
BackgroundAmong the various causes of death, colorectal carcinoma represents the second highest cause in frequency both in men and in women. A colorectal cancer is diagnosed every 3.5 minutes and a person dies of colorectal cancer every 9 minutes. In 2018, in Italy were recorded around 51.000 new cases, with a mortality rate of over 18.000 deaths. There is clear evidence demonstrating that the identification and treatment of cancer at an early stage positively influence the reduction in mortality. Colonoscopy is the most effective technique used to identify and remove polyps, thus avoiding the costs related to surgical treatment and hospitalization.The purpose of this study is to evaluate the costs of the system Endotics for robotic colonoscopy as an alternative to conventional diagnostic colonoscopy performed under anaesthesia at the University Hospital of Pisa.MethodsThe cost analysis was developed according to the Budget Impact Analysis method application, an essential and complementary part of the Health Technology Assessment evaluation, which has the main purpose of assessing the financial sustainability of new health technology, estimating the consequences of its use and diffusion in a specific context characterized by the limited availability of resources. The observation period covered a time interval of 3 months, during which an average of 43 colonoscopic procedures per day was performed and mapped and a total of 23 colonoscopes were used. ResultsOverall, the work done has allowed identifying the cost of a conventional painless diagnostic colonoscopy performed in our institution which amounts to € 426.25. The valuation of the costs of the robotic colonoscopy amounted overall to € 441.25.ConclusionsThe ideal procedure to diagnose a colon disease should be safe, well-tolerated, possibly non-invasive, with high diagnostic accuracy and, not least, cost-effectiveness. The results of this study suggest that in the University Hospital of Pisa the costs related to robotic colonoscopy performed with the Endotics system are superimposable to those of conventional painless colonoscopy, reducing the overall risk associated with the colonoscopic procedure maintaining a high diagnostic accuracy with a greater tolerability by the patient, thus pushing the colonoscopy towards “the ideal procedure”.
Demographic and comorbidity predictors of adherence to diagnostic colonoscopy in the Danish Colorectal Cancer Screening Program: a nationwide cross-sectional study
