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

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214 Screening for Colorectal Cancer KCE reports vol.45 Study, country, Analytic technique O Leary et al. (2004) Australia CEA Time window, Discount % A 10-year timeframe. Discount rate: 5% Perspective Interventions and population Cost items included From the perspective of the governmentfunded health system. No screening versus: - flexible SIG (every 10 years) - COL (every 10 years) - annual and biennial FOBT (rehydrated hemoccult) Individuals aged 55-64 years Year of pricing - FOBT (AUD26.40) - pathology tests (AUD70) - COL (AUD897) - COL with polypectomy (AUD1325) - surgery for adenoma removal (AUD5717) - chemotherapy (AUD9063) - radiotherapy (AUD7980) - perforation (AUD15 777) - cost detection when no screening (AUD83.90) - cost of treatment stage A: AUD15 318 stage B: AUD29 804 stage C: AUD23 021 stage D: AUD5596 - GP visit: AUD28.75 - specialist visit: AUD67.65 - investigation cost when no screening: AUD1463 - investigation cost when screening: AUD1395 - program administration cost: AUD75.13 per invited person Year of pricing: 2001 Sensitivity analysis Results One-way sensitivity analysis: - adenoma > 10mm progressing to cancer - discount costs (0, 10%) - discount outcomes (0, 10%) - cost COL (AUD718, 1076) - administrative cost screening program (AUD0, 100) - compliance screening program (40, 100% versus baseline 42% for COL and SIG and 60% for FOBT) ICER per extra life year compared with no screening: - Flexible sigmoidoscopy: AUD16 801 - colonoscopy: AUD19 285 - Biennal FOBT: AUD41 183 - Annual FOBT: AUD46 900 1AUD = 0.60
KCE reports vol.45 Screening for Colorectal Cancer 215 Study, country, Analytic technique Ladabaum et al. (2005) USA CEA Time window, Discount % Individuals progress through the model for 50 one-year cycles, until age 100 years or death. Discount rate: 3% Perspective Interventions and population Cost items included Third party payer perspective. No screening versus: - annual FOBT, - flexible SIG (every 5 years) - FOBT/FSIG combined, - COL (every 10 years) emerging strategies: - faecal DNA testing (every 5 years) with different test performance characteristics (F-DNA-base and F- DNA-optimized), - virtual colonoscopy every 10 years, modelled with midrange published values (VC-base) and a good case scenario (VC-Pickhardt) Individuals aged 50 years. Screening and surveillance were performed from age 50 years up to and including age 80 years. Year of pricing - FOBT ($20) - COL ($820) - COL + biopsy or lesion removal ($1200) - endoscopy complication ($26 000) - CRC treatment localized ($46 000) regional ($68 000) distant ($71 000) Year of pricing: 2003 Sensitivity analysis Results No sensitivity analysis on costeffectiveness estimates Compared with no screening, cost per LYG: - FOBT: $8100, - FSIG: $17 300, - FOBT/FSIG: $18 700 - COL: $18 800, - F-DNA-base: $73 200, - F-DNA-optimized: $31 000, - VC-base: $28 700 - VC-Pickhardt: $26 600 1$ = 0.79
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KCE reports vol.45A Colorectale Kan
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2 Screening for Colorectal Cancer K
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10 Screening for Colorectal Cancer
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