Cost of quality management and information provision for screening: colorectal cancer screening

Objective To estimate the costs of a quality management (QM) system as proposed by the Quality Management for Screening report for a future national colorectal cancer screening programme. Methods Estimates of the costs of the QM system, including the associated costs of education and training and information provision, were based on expert opinion, the existing literature, and the experience of the current National Health Service (NHS) breast cancer screening programme (BSP) and the NHS cervical cancer screening programme (CSP). Results The cost of a QM system to support a national colorectal cancer programme in the UK was estimated as approximately £3.8 million a year. Further annual costs related to QM will include £500 000 for education and training and £200 000 for information provision. Adding these additional costs to a previously published UK economic evaluation of colorectal cancer screening increases the cost-utility ratio to approximately £6500 per quality adjusted life year gained (over an eight year follow up period). Conclusions Any new screening programme, or an existing one, must have QM to ensure that the quality of screening is high and to maintain the right balance between benefit and harm. The significant costs of such a QM system should be included in any economic evaluation of a screening programme.