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)
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<strong>KCE</strong> <strong>reports</strong> vol.45 Screen<strong>in</strong>g for Colorectal Cancer: Appendices 149<br />
8.2 RESULTS<br />
8.2.1 Basel<strong>in</strong>e analysis<br />
The results of the basel<strong>in</strong>e analysis for the age group of 50 to 74 years are<br />
presented <strong>in</strong> table 32. For the age group of 55 to 74 years results are presented<br />
<strong>in</strong> table 33.<br />
8.2.1.1 First screen<strong>in</strong>g round of a biennial screen<strong>in</strong>g program<br />
In the first screen<strong>in</strong>g round, a biennial mass screen<strong>in</strong>g program <strong>with</strong><br />
unrehydrated gFOBT <strong>in</strong> all <strong>in</strong>dividuals between 50 and 75 years of age is<br />
expected to cost the Belgian government 20 to 34,7 million per year,<br />
depend<strong>in</strong>g on the scenario chosen. The mail<strong>in</strong>g system is less expensive than the<br />
GP system. Mass screen<strong>in</strong>g leads to the detection of 989 colorectal cancers per<br />
year <strong>in</strong> the first round. This is about 13% of the total number of CRCs that are<br />
diagnosed <strong>in</strong> Belgium <strong>with</strong>out screen<strong>in</strong>g, a proportion which is considerably<br />
higher than the 3,7% that would be expected <strong>in</strong> this population consider<strong>in</strong>g that<br />
only half the population is reached each year and consider<strong>in</strong>g the <strong>in</strong>complete<br />
compliance. This is of course due to the earlier detection of CRC through the<br />
screen<strong>in</strong>g. The expected average cost per colorectal cancer detected is 22.771<br />
for the mail<strong>in</strong>g system and 37.576 for the GP system.<br />
Table 32: Results basel<strong>in</strong>e analysis age group 50-74<br />
50-74 GP system Mail<strong>in</strong>g system<br />
1st & 2nd year<br />
Budget impact 34.694.320 19.960.480<br />
95% CI 17.636.130 51.533.840 14.007.280 26.421.150<br />
Neoplasms detected<br />
CRC 989 989<br />
380 1.795 380 1.795<br />
adenoma 1.975 1.975<br />
769 3.810 769 3.810<br />
Cost per neoplasms detected<br />
CRC 37.576 22.771<br />
24.620 60.569 12.132 43.285<br />
CRC + adenoma 12.265 7.431<br />
8.488 17.578 4.287 13.564<br />
3rd year<br />
Budget impact 33.158.810 18.363.540<br />
95% CI 16.895.710 49.113.960 13.095.000 24.112.550<br />
Neoplasms detected<br />
CRC 707 707<br />
268 1.271 268 1.271<br />
adenoma 1.412 1.412<br />
536 2.669 536 2.669<br />
Cost per neoplasms detected<br />
CRC 50.271 29.488<br />
32.980 81.589 15.206 56.530<br />
CRC + adenoma 16.405 9.621<br />
11.371 23.628 5.489 18.141<br />
Restrict<strong>in</strong>g the screen<strong>in</strong>g program to people between 55 and 75 years of age<br />
dim<strong>in</strong>ishes the budgetary impact of both scenarios (table 33). In this age group,