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

206 Screening for Colorectal Cancer KCE reports vol.45
Study, country,
analytic technique
Flanagan et al. (2003)
Canada
CEA
Time window
Discount %
Costs and effects
were calculated over
a period of 25 years.
Discount rate: 5%
Perspective,
Trial
Payer s perspective
(government)
Primarily based on the
Funen RCT (used
parameter estimates
from the other trials
(Minnesota and
Nottingham) where
appropriate)
Interventions and
population
No screening versus
biennial CRC
screening using FOBT
(unrehydrated
Hemoccult II).
Individuals aged 50-74
years
Cost items included
Year of pricing
Head office, satellite and promotion (per year)
CAD15 000 000 - CAD30 000 000
Cost of detection:
FOBT kit (CAD4.65 - CAD9.30), Processing (per
FOBT) (CAD6 - CAD8), Consultation (per positive
FOBT) (CAD123.7 - CAD161.1), Colonoscopy (per
positive FOBT or follow-up to polyps) (CAD350 -
CAD425)
Cost of treatment:
- Polypectomy (CAD147)
- other treatment costs from base CRC model
Complications
- Perforation (0.17%), hemorrhage (0.03%), and
death (0.02%).
Follow-up
- COL (performed at three, five, and 10-year
intervals if polyps were found)
Year of pricing : not explicitly stated
Sensitivity analysis Result
One way sensitivity analysis:
- costs
- annual screening
- participation (76% 50%)
- age cohort (start ages from 40 to 60
and end ages from 60 to 90)
- discount rate (0%, 3% and 5%)
The ICER of biennial screening was
CAD11 907.
The ICER of annual screening was
CAD13 497.
When costs increased, the ICER was
CAD18 445 with biennial screening
and CAD19 893 with annual screening.
When the participation rate was
reduced from 67% to 50%, the biennial
screening became less cost effective
(CAD15 688).
1 CAD = 0.71