Community health workers employed to increase cancer screenings save health systems money
Employing community health workers to increase the number of cervical cancer and colorectal cancer screenings was a cost-effective strategy in certain circumstances, according to a recent analysis.
The study also showed that health systems that employed community health workers (CHWs) increased uptake of cancer screenings among minorities, suggesting the approach can also improve health equity.
“The Community Preventive Services Task Force recommends engaging community health workers to increase breast, cervical and colorectal cancer screenings on the basis of strong evidence of effectiveness,” Sharon Attipoe-Dorcoo, PhD, MPH, a health services and systems researcher affiliated with the CDC, and colleagues wrote in the American Journal of Preventive Medicine. “This systematic review examines the economic evidence of these interventions.”
The researchers reviewed 19 studies on the costs and economic benefits of engaging CHWs to increase appropriate cancer screenings in the United States, the United Kingdom and France.
According to the researchers, an intervention in Texas that used CHWs to increase cervical cancer screenings among Hispanic women aged 18 years and older reported an incremental cost-effectiveness ratio (ICER) of $762 per quality-adjusted life year (QALY) saved. A similar program in Washington targeted toward Vietnamese American women aged 20 to 79 years showed an ICER of $34,405 per QALY saved.
“Both incremental cost per QALY estimates for cervical cancer fell below a conservative threshold of $50,000 per QALY, implying that the interventions were cost effective,” the researchers wrote.
According to Attipoe-Dorcoo and colleagues, a New York-based intervention that attempted to boost colorectal cancer screenings among African Americans and Hispanics aged 50 years and older by employing CHWs reported both a negative incremental cost of $144 and an increase in QALYs saved of 0.014. Similarly, a program in Texas with the same intent geared toward Hispanic men aged older than 50 years reported a negative incremental cost of $1,219 and a 0.3 increase in QALYs saved.
The researchers said there were no studies that reported incremental costs per QALY saved as it related to using CHWs to increase breast cancer screenings.
“Most studies only reported incremental cost per additional person screened, which cannot be used for an absolute determination of cost effectiveness owing to the lack of an existing threshold,” they wrote.
Regardless, they still encouraged health care professionals to use CHWs.
“The evidence from this review indicates that engaging CHWs in cancer screening can be cost effective or may even generate net cost savings while simultaneously promoting health equity,” Attipoe-Dorcoo and colleagues wrote.