In Finland colorectal cancer (CRC) incidence rates have steadily increased over the last decades and as of 2017, CRC is the sixth most common cause of death. CRC is a crucial concern for the public health of Finland. We optimize the faecal immunochemical test (FIT) cut-off level for specified target populations with regard to minimization of cancer prevalence with Decision Programming, which is a novel approach to solving discrete multi-stage decision problems under uncertainty. The results present optimal cut-off levels for Finnish target groups with different colonoscopy capacity constraints. Finally, the estimated resulting cancer prevalence, the amount of required colonoscopies and third-party payer costs resulting from found strategies to the newly implemented Finnish CRC Screening Programme, which have not previously been published, are presented.
Comment: Working paper, 23 pages, 3 figures