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

KCE reports vol.45 Screening for Colorectal Cancer: Appendices 155
If we assume that our point estimate for participation is accurate, and fix this
variable at the value of 45% in the GP system, where participation is the single
most important uncertain factor, the most influential uncertain factors are (in
order of importance): fixed campaign costs, mailing costs, compliance with
colonoscopy after positive FOBT and positivity rate of FOBT in the first
screening round.
The uncertainty in the cost per CRC detected depends in first instance on
the uncertainty in the detection rate of CRC after a positive FOBT in both the
GP and mailing system. This was the most important factor in the GP system,
whereas in the mailing system also the uncertainty around the participation
rate, mailing costs, campaign costs and compliance with colonoscopy after
positive FOBT added to the uncertainty in the cost per CRC detected (Figure
16).
detection rate CRC
participation rate
mailing costs
fixed campaign costs
compliance w ith
colonoscopy after positive
FOBT
Figure 16: Influence diagram representing the sensitivity of the
estimated cost per CRC detected in the first screening round to
uncertain modelling parameters in the mailing system (age group 50-
74 years)
8.3 CAPACITY NEEDS
-0,8 -0,7 -0,6 -0,5 -0,4 -0,3 -0,2 -0,1 0 0,1 0,2 0,3
Correlation coefficients
Implementing a mass screening program requires resources, not only in terms
of money but also in terms of capacity. One of the major requirements is
sufficient capacity to perform colonoscopies.
From our baseline model with Hemoccult II, we concluded that 9890
colonoscopies per year would have to be performed in the first screening