Report in English with a Dutch summary (KCE reports 45A)
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Report in English with a Dutch summary (KCE reports 45A)

Report in English with a Dutch summary (KCE reports 45A) Report in English with a Dutch summary (KCE reports 45A)

kce.fgov.be
10.08.2013 Views

106 Screening for Colorectal Cancer KCE reports vol.45 Table 25: Economic evaluations appraised in the New Zealand HTA Whynes DK, Neilson AR, Walker AR, Hardcastle JD., 1998 489 Fecal occult blood screening for colorectal cancer: is it costeffective? Whynes DK, 1999 490 Cost-effectiveness of fecal occult blood screening for colorectal cancer: results of the Nottingham trial. Gyrd-Hansen D, Sogaard J, Kronborg O, 1998 491 Gyrd-Hansen D, 1998 492, will be called 1998b further in this chapter Colorectal cancer screening: efficiency and effectiveness. Fecal occult blood test: a cost-effectiveness analysis. Gyrd-Hansen D, 1999 493 The relative economics of screening for colorectal cancer, breast cancer and cervical cancer. Helm JF, Russo MW, Biddle AK, Simpson KN,, 2000 494 Sonnenberg A, Delco F, Inadomi JM., 2000 495 Frazier AL, Colditz GA, Fuchs CS, Kuntz KM., 2000 496 Loeve F, Brown ML, Boer R, van Ballegooijen M, van Oortmarssen GJ, Habbema JD., 2000 497 Flanagan WM, Le Petit C, Berthelot J-M, White KJ, Coombs BA, Jones-McLean E., 2003 498 Van Ballegooijen M, Habema, JDF., Boer, R., 2003 499 Berchi C, Bouvier V, Reaud J-M, Launoy G., 2004 271 O'Leary BA, Olynyk JK, Neville AM, Platell CF., 2004 500 Effectiveness and economic impact of screening for colorectal cancer by mass fecal occult blood testing. Cost-effectiveness of colonoscopy in screening for colorectal cancer. Cost-effectiveness of screening for colorectal cancer in the general population Endoscopic colorectal cancer screening: a cost-saving analysis. Potential impact of population-based colorectal cancer screening in Canada. A comparison of cost-effectiveness of fecal occult blood tests with different test characteristics in the context of annual screening in the medicare population. Cost-effectiveness analysis of two strategies for mass screening for colorectal cancer in France Cost-effectiveness of colorectal cancer screening: comparison of community-based flexible sigmoidoscopy with fecal occult blood testing and colonoscopy. Whynes DK., 2004 501 Cost-effectiveness of screening for colorectal cancer: evidence from the Nottingham fecal occult blood trial Stone CA, Carter RC, Vos T, John JS., 2004 502 Colorectal cancer screening in Australia: an economic evaluation of a potential biennial screening program using fecal occult blood tests. We have examined the 15 articles from the point of view of potential screening strategies that could be implemented in Belgium (FOBT and colonoscopy) and we have selected 14 articles out of those 15 studies. One article 497 has been rejected from our analysis as the study is mainly dealing with sigmoidoscopic colorectal cancer screening and it did not take into account FOBT or colonoscopy screening as an alternative choice. Table 26 lists the studies retained from the incremental literature search. As mentioned previously we have focussed on economic evaluation studies that compared no screening versus at least one of the two screening strategies we considered for Belgium: FOBT and colonoscopy. We finally retained seven primary research studies for this report: three studies were conducted in USA, and the other in Singapore, France, Israel and Taiwan. We decided to include one study from 2003 that was originally excluded from the New Zealand HTA report 503. We kept this study in our review because it compared different

KCE reports vol.45 Screening for Colorectal Cancer 107 screening strategies including colonoscopy. Only one of the included studies 504 was based on a newly published controlled trial (the Burgundy trial in France). The publication from Ramsey et al. 111 is not about mass screening but a study on how to detect individuals with increased risk based on family history assessment through GP questioning. Therefore, this study will not be evaluated in this chapter. Table 26: Economic literature KCE incremental search (2004-2006) Leshno M, Halpern Z, et al., 2003 503 Cost-effectiveness of colorectal cancer screening in the average risk population." Lejeune C, Arveux P, et al., 2004 504 Cost-effectiveness analysis of fecal occult blood screening for colorectal cancer Wong SS, Leong APK, et al., 2004 505 Cost-effectiveness analysis of colorectal cancer screening strategies in Singapore: a dynamic decision analytic approach. Ramsey SD, Burke W, et al., 2005 111 Family history assessment to detect increased risk for colorectal cancer: conceptual considerations and a preliminary economic analysis. Ladabaum U, Song K., 2005 506 Projected national impact of colorectal cancer screening on clinical and economic outcomes and health services demand Maciosek MV, Solberg LI, et al., 2006 507 Colorectal cancer screening health impact and cost effectiveness Wu GHM, Wang YW, Yen AMF, Wong JM, Lai HC, Warwick J, et al., 2006 342 6.3 ECONOMIC LITERATURE REVIEW Cost-effectiveness analysis of colorectal cancer screening with stool DNA testing in intermediate-incidence countries. The detailed evidence tables of these economic evaluations can be found in appendix 6.3.1 Methodology 6.3.1.1 Data The clinical and cost data for the studies comparing FOBT screening versus no screening are in the first place drawn from the three major RCTs (Funen-1 (Denmark), Nottingham (UK) and Minnesota (US)). A recent study 504 was based on the controlled Burgundy trial. These data were supplemented by values from literature, national incidence/mortality data, and relevant cost data based on the specific health care systems. In contrast with the RCT based FOBT studies, the scenarios analysing immunochemical FOBT and/or colonoscopy (and other screening alternatives) are not supported by data from RCTs. Almost all studies are cost effectiveness analyses. Only Whynes 489, 490 and Stone 502 performed a cost utility analysis. The study by Whynes et al. expressed results as costs per Quality Adjusted Life Year gained (QALYs) and the quality of life data were taken from earlier empirical investigations 508, 509. The study by Stone et al. calculated costs per disability adjusted life years (DALYs) using the Burden of Disease methodology 510. 6.3.1.2 Perspective of the studies The perspective of almost all included studies is that of the third-party payer in a governmentally funded health system. Although the study of Frazier 496 claims to use a societal perspective, only direct costs to the health care system were

106 Screen<strong>in</strong>g for Colorectal Cancer <strong>KCE</strong> <strong>reports</strong> vol.45<br />

Table 25: Economic evaluations appraised <strong>in</strong> the New Zealand HTA<br />

Whynes DK, Neilson AR, Walker AR,<br />

Hardcastle JD., 1998 489<br />

Fecal occult blood screen<strong>in</strong>g for colorectal cancer: is it costeffective?<br />

Whynes DK, 1999 490 Cost-effectiveness of fecal occult blood screen<strong>in</strong>g for colorectal<br />

cancer: results of the Nott<strong>in</strong>gham trial.<br />

Gyrd-Hansen D, Sogaard J, Kronborg O,<br />

1998 491<br />

Gyrd-Hansen D, 1998 492, will be called<br />

1998b further <strong>in</strong> this chapter<br />

Colorectal cancer screen<strong>in</strong>g: efficiency and effectiveness.<br />

Fecal occult blood test: a cost-effectiveness analysis.<br />

Gyrd-Hansen D, 1999 493 The relative economics of screen<strong>in</strong>g for colorectal cancer, breast<br />

cancer and cervical cancer.<br />

Helm JF, Russo MW, Biddle AK, Simpson<br />

KN,, 2000 494<br />

Sonnenberg A, Delco F, Inadomi JM.,<br />

2000 495<br />

Frazier AL, Colditz GA, Fuchs CS, Kuntz<br />

KM., 2000 496<br />

Loeve F, Brown ML, Boer R, van<br />

Ballegooijen M, van Oortmarssen GJ,<br />

Habbema JD., 2000 497<br />

Flanagan WM, Le Petit C, Berthelot J-M,<br />

White KJ, Coombs BA, Jones-McLean E.,<br />

2003 498<br />

Van Ballegooijen M, Habema, JDF., Boer,<br />

R., 2003 499<br />

Berchi C, Bouvier V, Reaud J-M, Launoy<br />

G., 2004 271<br />

O'Leary BA, Olynyk JK, Neville AM, Platell<br />

CF., 2004 500<br />

Effectiveness and economic impact of screen<strong>in</strong>g for colorectal<br />

cancer by mass fecal occult blood test<strong>in</strong>g.<br />

Cost-effectiveness of colonoscopy <strong>in</strong> screen<strong>in</strong>g for colorectal<br />

cancer.<br />

Cost-effectiveness of screen<strong>in</strong>g for colorectal cancer <strong>in</strong> the general<br />

population<br />

Endoscopic colorectal cancer screen<strong>in</strong>g: a cost-sav<strong>in</strong>g analysis.<br />

Potential impact of population-based colorectal cancer screen<strong>in</strong>g <strong>in</strong><br />

Canada.<br />

A comparison of cost-effectiveness of fecal occult blood tests <strong>with</strong><br />

different test characteristics <strong>in</strong> the context of annual screen<strong>in</strong>g <strong>in</strong><br />

the medicare population.<br />

Cost-effectiveness analysis of two strategies for mass screen<strong>in</strong>g for<br />

colorectal cancer <strong>in</strong> France<br />

Cost-effectiveness of colorectal cancer screen<strong>in</strong>g: comparison of<br />

community-based flexible sigmoidoscopy <strong>with</strong> fecal occult blood<br />

test<strong>in</strong>g and colonoscopy.<br />

Whynes DK., 2004 501 Cost-effectiveness of screen<strong>in</strong>g for colorectal cancer: evidence from<br />

the Nott<strong>in</strong>gham fecal occult blood trial<br />

Stone CA, Carter RC, Vos T, John JS.,<br />

2004 502<br />

Colorectal cancer screen<strong>in</strong>g <strong>in</strong> Australia: an economic evaluation of<br />

a potential biennial screen<strong>in</strong>g program us<strong>in</strong>g fecal occult blood tests.<br />

We have exam<strong>in</strong>ed the 15 articles from the po<strong>in</strong>t of view of potential screen<strong>in</strong>g<br />

strategies that could be implemented <strong>in</strong> Belgium (FOBT and colonoscopy) and<br />

we have selected 14 articles out of those 15 studies. One article 497 has been<br />

rejected from our analysis as the study is ma<strong>in</strong>ly deal<strong>in</strong>g <strong>with</strong> sigmoidoscopic<br />

colorectal cancer screen<strong>in</strong>g and it did not take <strong>in</strong>to account FOBT or<br />

colonoscopy screen<strong>in</strong>g as an alternative choice.<br />

Table 26 lists the studies reta<strong>in</strong>ed from the <strong>in</strong>cremental literature search. As<br />

mentioned previously we have focussed on economic evaluation studies that<br />

compared no screen<strong>in</strong>g versus at least one of the two screen<strong>in</strong>g strategies we<br />

considered for Belgium: FOBT and colonoscopy. We f<strong>in</strong>ally reta<strong>in</strong>ed seven<br />

primary research studies for this report: three studies were conducted <strong>in</strong> USA,<br />

and the other <strong>in</strong> S<strong>in</strong>gapore, France, Israel and Taiwan. We decided to <strong>in</strong>clude<br />

one study from 2003 that was orig<strong>in</strong>ally excluded from the New Zealand HTA<br />

report 503. We kept this study <strong>in</strong> our review because it compared different

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