{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T08:09:02Z","timestamp":1778400542917,"version":"3.51.4"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Cancer Institute of the US National Institutes of Health","award":["U01-CA253913"],"award-info":[{"award-number":["U01-CA253913"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Med Screen"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Given steady increases in age-standardized colorectal cancer incidence, health authorities in Mexico could consider implementing a colorectal cancer screening program. To inform program design, we evaluated the cost-effectiveness of fecal immunochemical testing (FIT) among a hypothetical cohort of 45-year-old residents of Mexico City. We adapted a validated US microsimulation model of colorectal cancer to reflect epidemiological outcomes in Mexico City.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the adapted model, we estimated the lifetime health outcomes and costs associated with no screening and with FIT strategies that varied by the start age, end age, screening interval, and hemoglobin threshold for colonoscopy referral. We obtained costs from published reports and formularies. We calculated incremental cost-effectiveness ratios and identified the cost-effective FIT strategy as the strategy with the highest ratio below the willingness-to-pay threshold of 381,000 MXN per quality-adjusted life-year (QALY) gained (i.e., three times Mexico's per-capita Gross Domestic Product).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with no screening, the effectiveness of FIT screening ranged from 23 to 49 QALYs gained per 1000 45-year-olds. Biennial FIT from age 50 to 70 with the most lenient threshold for colonoscopy referral (10\u2005\u03bcg of hemoglobin\/g of feces) was the cost-effective strategy. The starting age of screening was sensitive to assumptions about the cost of unreturned test kits, outreach costs, and colorectal cancer risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Screening for colorectal cancer with FIT may be cost-effective in Mexico City. Additional studies are needed to assess whether the colonoscopy capacity is sufficient to support a lenient referral threshold.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09691413261443051","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T13:02:28Z","timestamp":1778158948000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness of fecal immunochemical testing for colorectal cancer in Mexico City: A microsimulation modeling study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1076-5563","authenticated-orcid":false,"given":"Claudia L","family":"Seguin","sequence":"first","affiliation":[{"name":"Institute for Technology Assessment, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA"},{"name":"Department of Health Policy, School of Medicine, Stanford University, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2624-4850","authenticated-orcid":false,"given":"Andrea","family":"Luviano","sequence":"additional","affiliation":[{"name":"PhD Program in Health Policy, Harvard University, Cambridge, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen M","family":"Kuntz","sequence":"additional","affiliation":[{"name":"University of Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8471-4128","authenticated-orcid":false,"given":"Martin","family":"Lajous","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Salud P\u00fablica"},{"name":"Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8643-1113","authenticated-orcid":false,"given":"M\u00f3nica Isabel","family":"Meneses Medina","sequence":"additional","affiliation":[{"name":"Departamento de Hematolog\u00eda y Oncolog\u00eda, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n \u201cSalvador Zubir\u00e1n\u201d, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fidel David","family":"Huitzil Mel\u00e9ndez","sequence":"additional","affiliation":[{"name":"Departamento de Hematolog\u00eda y Oncolog\u00eda, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n \u201cSalvador Zubir\u00e1n\u201d, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6753-0116","authenticated-orcid":false,"given":"Maria Del Carmen","family":"Manzano-Robleda","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cancerolog\u00eda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8478-9659","authenticated-orcid":false,"given":"Jose Maria","family":"Remes-Troche","sequence":"additional","affiliation":[{"name":"Instituto de Investigaciones M\u00e9dico Biol\u00f3gicas, Universidad Veracruzana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9010-1582","authenticated-orcid":false,"given":"Juan A","family":"Villanueva-Herrero","sequence":"additional","affiliation":[{"name":"Hospital General de M\u00e9xico \u201cDr Eduardo Liceaga\u201d"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3446-8130","authenticated-orcid":false,"given":"Susana","family":"Lozano Esparza","sequence":"additional","affiliation":[{"name":"University of Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9322-2520","authenticated-orcid":false,"given":"Anna P","family":"Lietz","sequence":"additional","affiliation":[{"name":"Institute for Technology Assessment, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5263-756X","authenticated-orcid":false,"given":"Andrew L","family":"Eckel","sequence":"additional","affiliation":[{"name":"Institute for Technology Assessment, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5076-1172","authenticated-orcid":false,"given":"Fernando","family":"Alarid-Escudero","sequence":"additional","affiliation":[{"name":"Department of Health Policy, School of Medicine, Stanford University, Stanford, CA, USA"},{"name":"Center for Health Policy, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1872-996X","authenticated-orcid":false,"given":"Amy B","family":"Knudsen","sequence":"additional","affiliation":[{"name":"Institute for Technology Assessment, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Programa De Acci\u00f3n Espec\u00edfico de Prevenci\u00f3n y Control del C\u00e1ncer 2021\u20132024 https:\/\/www.gob.mx\/cms\/uploads\/attachment\/file\/706943\/PAE_CAN_cF.pdf (2021 accessed December 9 2024)."},{"key":"e_1_3_2_3_2","unstructured":"Global Burden of Disease Collaborative Network. 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