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

208 Screening for Colorectal Cancer KCE reports vol.45
Study, country,
analytic technique
Lejeune et al.
(2004)
France
CEA
Time window
Discount %
Modelling over a 10
and 20-year period, or
until the age of 85, or
until death.
Discount rate: 3%
Perspective,
Trial
The French healthcare
insurance system
Burgundy trial
Interventions and
population
No screening versus
biennial screening
using FOBT
(Hemoccult-II).
Individuals aged 50 to
74 years.
Cost items included
Year of pricing
- organizational costs ( 1.26 per target individual)
(incl. labour costs and equipment);
- invitations ( 0.65 per target individual), (incl.
conception and printing of the letter and of the
information leaflet sent, preparing the mailing, the
cast of postage, training the GP and informing the
entire medical profession),
- cost screening test ( 12.52 per test) (incl. cost of
test, remuneration GP for offering the test, cost of
mailing the test or the reminder letter),
- test analysis ( 4 per test) (incl. overhead costs,
capital expenditure, running costs, and labour costs),
- COL ( 526). In the case of polypectomy, the cost
was 641.
Some other costs were obtained from published
sources.
- Treatment cost: stage I: 15 579, Stage II: 21 858
, Stage III: 31 110, stage IV: 17 384
- Follow-up: 843 per patient (over a 5-year period)
Year of pricing: 2002
Sensitivity analysis Result
One-way sensitivity analysis:
- acceptability rate FOBT (+10ppt, -
10ppt, -20ppt)
- diagnostic performance FOBT
(sensitivity: 60 70%, specificity: 99
90%)
- cost of test kit (-50%)
- COL (min: 225 ; max: 830)
- polypectomy (min: 330 ; max:
1000)
- treatment:
Minimum st.I: 14 063; st.II: 17 486;
st.III: 24 888; st.IV: 13 907
Maximum st.I: 21 055; st.II: 26 230;
st.III: 37 332; st.IV: 20 861
- starting and end ages
- undiscounted LYG
ICER:
- 3357 / LYG (over 20 years)
- 4705 / LYG (over 10 years)