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SENSS has substantial experience in reviewing and modelling colorectal cancer (CRC) screening. We have conducted multiple projects addressing key aspects of the UK bowel screening programme, spanning from 2010 to 2026, demonstrating deep expertise in cost-effectiveness modelling, health economics, and systematic review methods applied to CRC screening.
What is Colorectal Cancer?
What is Colorectal Cancer?
Colorectal cancer (CRC) is a type of cancer that develops in the colon (the longest part of the large intestine) or the rectum (the final few inches of the large intestine). It is often referred to as bowel cancer. It typically begins when cells in the lining of the colon or rectum grow and change uncontrollably, often starting as non-cancerous growths called polyps. Over time, some of these polyps can become cancerous.
Why is screening for CRC important?
Why is screening for CRC important?
Screening for CRC is critically important because it is highly effective in both preventing the disease and catching it early when it is most curable. When colorectal cancer is found at its earliest, localised stage (before it has spread), the 5-year relative survival rate is about 90%.
Symptoms often appear late: In its early stages, colorectal cancer usually produces no symptoms. By the time symptoms like abdominal pain or significant changes in bowel habits occur, the cancer may have already advanced and spread to other parts of the body. The survival rate drops significantly once the cancer has spread to distant parts of the body (to around 13% for distant metastases, according to some sources).
Multiple studies and global health initiatives have shown that regular colorectal cancer screening significantly reduces the number of deaths from the disease.
Our expertise in colorectal cancer
Our expertise in colorectal cancer
Cost-effectiveness model (2020)
The English Bowel Cancer Screening Programme invites people between the ages of 60 and 74 to take a Faecal Immunochemical Test every two years. This programme was interrupted during the coronavirus pandemic. The research aimed: (1) to estimate the impact of colorectal cancer (CRC) Faecal Immunochemical Test screening pauses of different lengths and the actual coronavirus-related screening pause in England, and (2) to analyse the most effective and cost-effective strategies to re-start CRC screening to prepare for future disruptions.doi.org/10.1016/j.ypmed.2022.107076
Reviewing and cost-effectiveness model (2020)
Colorectal cancer (CRC) incidence and mortality is higher in socioeconomically deprived groups for a variety of reasons, but is exacerbated by poorer screening uptake. However, many strategies for improving screening participation exist. This analysis aimed to model the impact of screening on CRC inequalities in England and then compare different strategies for increasing participation, to determine the most cost-effective methods for reducing screening-induced inequalities.doi.org/10.1016/j.ypmed.2022.107131
Cost-effectiveness model: ongoing (2023-2026)
Colorectal cancer (CRC) is the fourth most common cancer in the UK and the second leading cause of cancer deaths. Early detection is crucial, as it drastically increases the chances of successful treatment. However, people living in areas with higher poverty levels (socio-economically deprived areas) often have lower rates of CRC screening and thus receive later diagnoses, leading to poorer outcomes. The main aim of the study is to assess the feasibility of active case finding in high street pharmacies to identify patients with colorectal cancer.doi.org/10.1186/ISRCTN14156362Cost-effectiveness model: ongoing (2019-2025)
This study will investigate if spraying a blue dye in the upper large bowel helps the doctor to detect more flat polyps during the colonoscopy. At the moment it is not known if spraying the dye in the upper large bowel is the best way to improve detection so participants who are due to have a screening colonoscopy will be randomly assigned into two groups; one to have a standard colonoscopy and the other to have a colonoscopy using the dye spray. This will allow a comparison of what happens between the two groups. The aim is to find out through this study if this method works in practice and improves the detection and removal of more serrated polyps within the screening programme.doi.org/10.1186/ISRCTN98539180Cost-effectiveness model (2018-2019)
Population-based screening for colorectal cancer is an effective and cost-effective way of reducing colorectal cancer incidence and mortality. Many genetic and phenotypic risk factors for colorectal cancer have been identified, leading to development of colorectal cancer risk scores with varying discrimination. However, these are not currently used by population screening programs. We performed an economic analysis to assess the cost-effectiveness, clinical outcomes, and resource impact of using risk-stratification based on phenotypic and genetic risk, taking a UK National Health Service perspective.doi.org/10.1158/1940-6207.CAPR-20-0620Cost-effectiveness model (2021)
Men have a greater risk of colorectal cancer (CRC) than women, but population screening currently starts at the same age for both sexes. This analysis investigates whether, in a resource-constrained setting, it would be more effective and cost-effective for men and women to start screening for CRC at different ages.doi.org/10.1002/cnr2.1344REF 2021 Impact Case Study (2010-2016)
Sheffield research provided key evidence to inform national policy recommendations and implementation of bowel cancer screening in the UK. Refining and optimising bowel cancer screening programmes from gFOBT to FIT enables the NHS to save costs, reduce cancer morbidity, save lives and in some cases prevent potential harm associated with screening.results2021.ref.ac.uk/impact/0a76b8e5-833b-4a98-9f38-47caca892ba6
Programme evaluation (2019-2020)
Sheffield research provided key evidence to inform national policy recommendations and implementation of bowel cancer screening in the UK. Refining and optimising bowel cancer screening programmes from gFOBT to FIT enables the NHS to save costs, reduce cancer morbidity, save lives and in some cases prevent potential harm associated with screening.scholar.google.co.uk/scholar?oi=bibs&cluster=12506700434501897007&btnI=1&hl=enKey publications
Key publications
Modelling cost-effective strategies for minimising socioeconomic inequalities in colorectal cancer screening outcomes in England
Modelling cost-effective strategies for minimising socioeconomic inequalities in colorectal cancer screening outcomes in England
Published in Preventive Medicine Reports, 2022: 162:107131
Optimising the design of a repeated fecal immunochemical test Bowel Cancer screening programme with a limited endoscopy capacity from a Health Economic perspective
Optimising the design of a repeated fecal immunochemical test Bowel Cancer screening programme with a limited endoscopy capacity from a Health Economic perspective
Published in Value in Health, 2022: 25: 954–964
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