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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152 Screen<strong>in</strong>g for Colorectal Cancer: Appendices <strong>KCE</strong> <strong>reports</strong> vol.45<br />
Table 34: Incremental cost-effectiveness, <strong>in</strong> terms of cost per CRC<br />
detected, of screen<strong>in</strong>g different age groups<br />
Cost GP system Cost mail<strong>in</strong>g system<br />
CRC<br />
detected<br />
1st round<br />
50-74 34.694.320 19.960.480 989<br />
55-74 26.497.220 15.457.430 741<br />
Incremental value 8.197.100 4.503.050 248<br />
95% C.I. 3.955.395 12.481.470 3.074.823 6.054.114 95 450<br />
Cost / add. CRC detected 33.053 18.157<br />
95% C.I. 23.037 56.621 10.959 37.515<br />
2nd round<br />
50-74 33.158.810 18.363.540 707<br />
55-74 25.346.690 14.260.870 530<br />
Incremental value 7.812.120 4.102.670 177<br />
95% C.I. 3.752.111 11.800.700 2.817.188 5.515.838 67 319<br />
Cost / add. CRC detected 44.136 23.179<br />
95% C.I. 31.119 75.324 13.604 49.341<br />
The relevance of these figures is limited to show<strong>in</strong>g that extend<strong>in</strong>g the<br />
population from 55- to 74-year-olds to 50- to 74-year-olds is associated <strong>with</strong> an<br />
additional cost per additional CRC detected. Whether the additional yield <strong>in</strong><br />
terms of CRC detected is worth the extra costs depends, among other, on the<br />
sav<strong>in</strong>gs associated <strong>with</strong> avoid<strong>in</strong>g treatment and the value of life years ga<strong>in</strong>ed<br />
and/or quality of life impairment avoided.<br />
8.2.2 Comparison between different FOBTs<br />
The results of the model that compared different FOBTs are presented <strong>in</strong> Table<br />
35. We only present the results for the first round <strong>in</strong> a mail<strong>in</strong>g system and for<br />
the age group of 50 to 74 years, as the results for the GP system, subsequent<br />
rounds and the more limited age group are similar as far as the relation<br />
between the different tests is concerned.<br />
The Hemoccult II test has the lowest budgetary impact, <strong>with</strong> a total cost to the<br />
government of 20,8 million per year <strong>in</strong> the first screen<strong>in</strong>g round. The<br />
Hemoccult II is, however, the least effective <strong>in</strong> detect<strong>in</strong>g CRC. The Hemoccult<br />
II Sensa has the highest budget impact and is the most effective for detect<strong>in</strong>g<br />
CRC, however at the cost of more false positives. The expected cost of<br />
screen<strong>in</strong>g <strong>with</strong> the Hemoccult II Sensa <strong>in</strong> all people between 50 and 75 years of<br />
age is 48,4 million per year <strong>in</strong> the first screen<strong>in</strong>g round and the expected<br />
number of colorectal cancers detected is 1.609.