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

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216 Screening for Colorectal Cancer KCE reports vol.45 Study, country, Analytic technique Maciosek et al. (2006) USA CEA Time window, Discount % Lifetime horizon Discount rate: 3% Perspective Interventions and population Cost items included Societal perspective no screening versus screening with: - annual FOBT, - SIG every 5 years - COL every 10 years People aged 50 years and older. Year of pricing - Cost FOBT: $18, - Cost COL $572, - COL with tissue removal: $796 Net costs: (derived from Vijan study) 598 - value of resources used in providing the preventive service - plus any follow-up services, - minus the resource savings from averted disease or injury. Discounted net costs: - FOBT: $183 - COL: $323 Adjustment for time cost: - $109 for annual FOBT - $55 for 10-year COL Year of pricing: 2000 Sensitivity analysis Results One-way sensitivity analysis - discount rate - adherence with screening and follow-up ICER: - FOBT: $13 334/LYG - SIG: $18 869/LYG - COL: $8840/LYG Weighted average : $11 947/LYG Weights = relative delivery of FOBT (48%), SIG (9%) and COL (43%) in 2003 1$ = 0.79
KCE reports vol.45 Screening for Colorectal Cancer 217 Study, country, Analytic technique Wu et al. (2006) Taiwan CEA Time window, Discount % Cohort followed for 25 years Discount rate: 3% Perspective Interventions and population Cost items included third-party payer perspective No screening versus: - stool DNA testing (triennial, fiveyearly, and ten-yearly) - no screening - annual FOBT - flexible sigmoidoscopy (5-yearly) - colonoscopy (10-yearly) Population aged 50 to 75 years. Year of pricing Screening: - FOBT ($0.6) - Colonoscopy ($66.2) Treatment and confirmation: - Pathological examination ($20.6) - Biopsy ($13.2) - Polypectomy ($42.4) - Initial cost for early CRC ($3117.6) - Initial cost for late CRC ($7705.9) - Continuing cost for CRC ($176.5) - Terminal Care for CRC ($7647.1) - Complication cost for perforation ($1617.6) - Complication cost for death ($2735.3) Year of pricing: 2004 Sensitivity analysis Results One-way sensitivity analysis identifying the influential parameters on ICER for stool DNA testing compared with no screening: - the prevalence of colorectal neoplasm at age 50 years, - transition rates, - sensitivity and specificity of screening tool, - cost of per unit of stool DNA testing, - compliance to screening tool, - referral rate to diagnostic colonoscopy, - cost of treatment - discount rate 10-yearly colonoscopy and yearly FOBT are the most cost-effective strategies which are more effective and less costly than no screening. The ICERs were: - FOBT: dominant, - colonoscopy: dominant, - sigmoidoscopy: $2087, - stool DNA testing every three years: $9794, - stool DNA testing every five years: $9335, - Stool DNA testing every ten years: $7717
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KCE reports vol.45A Colorectale Kan
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