Appendix Table 1.
Cost estimates and simulated number of life-years for colorectal cancer care per 1000 individuals for the near-future scenario by stage, phase of care, and screening strategy*
| Initial care |
Continuous care |
Terminal care, death from colorectal cancer |
Terminal colorectal cancer care, death other causes |
Treatment of colorectal cancer costs, $† | |||||||||||||
| Strategy | Stage I | Stage II | Stage III | Stage IV | Stage I | Stage II | Stage III | Stage IV | Stage I | Stage II | Stage III | Stage IV | Stage I | Stage II | Stage III | Stage IV | |
| Yearly cost inputs | 28 668 | 39 700 | 79 801 | 79 801 | 2395 | 2237 | 3249 | 10 419 | 111 935 | 111 712 | 114 776 | 133 522 | 12 703 | 11 035 | 14 708 | 39 679 | |
| Life-years | |||||||||||||||||
| No screening | 5.6 | 10.0 | 6.6 | 3.3 | 65.2 | 93.9 | 59.8 | 8.5 | 0.5 | 2.3 | 2.6 | 5.1 | 3.8 | 6.2 | 3.5 | 0.7 | 3 490 000 |
| Hem II | 11.4 | 4.8 | 2.7 | 1.0 | 137.8 | 53.8 | 31.6 | 3.0 | 1.0 | 1.2 | 1.1 | 1.5 | 7.0 | 2.9 | 1.5 | 0.2 | 2 112 000 |
| iFOBT | 11.1 | 3.6 | 2.0 | 0.6 | 137.3 | 42.1 | 24.7 | 2.2 | 0.9 | 0.9 | 0.8 | 1.0 | 6.7 | 2.2 | 1.1 | 0.1 | 1 757 000 |
| Flexsig | 7.0 | 4.5 | 2.8 | 1.1 | 85.3 | 51.0 | 31.7 | 3.3 | 0.6 | 1.1 | 1.1 | 1.7 | 4.5 | 2.7 | 1.5 | 0.2 | 1 804 000 |
| Cscopy | 7.3 | 3.7 | 2.2 | 0.7 | 88.7 | 43.6 | 27.2 | 2.5 | 0.6 | 0.9 | 0.9 | 1.2 | 4.7 | 2.2 | 1.2 | 0.1 | 1 554 000 |
| Flexsig + Hem II | 8.7 | 3.5 | 2.0 | 0.6 | 107.1 | 42.0 | 25.3 | 2.2 | 0.7 | 0.9 | 0.8 | 1.0 | 5.4 | 2.2 | 1.1 | 0.1 | 1 582 000 |
Costs for care were divided into three clinically relevant phases of care—initial, continuing, and terminal care. The initial phase was defined as the first 12 months following diagnosis, the terminal phase was defined as the final 12 months of life, and the continuing phase was defined as the period between the initial and terminal phases of care. The terminal care phase of colorectal cancer patients was further subdivided into terminal care preceding colorectal cancer death and terminal care preceding death of other causes. For patients surviving less than 24 months after diagnosis, the final 12 months of observation and costs of care were then allocated first to the terminal phase. The remaining time was allocated to the initial phase, with no contribution to the continuing phase. Hem II = Hemoccult II; iFOBT = immunochemical fecal occult blood test; Flexsig = flexible sigmoidoscopy; Cscopy = colonoscopy; Flexsig + Hem II = flexible sigmoidoscopy and Hemccult II.
Average costs for colorectal cancer treatment per 1000 individuals in the population, excluding costs of diagnosis of symptom-detected cases. Calculated as sum of yearly cost inputs multiplied by the number of life-years with care by phase and stage of disease. For example, treatment costs in the No-screening strategy are equal to 5.6 × $28 668 + 10.0 × $39 700 + 6.6 × $79 801 + 3.3 × $79 801 + 65.2 × $2395 + 93.9 × $2237 + 59.8 × $3249 + 8.5 × $10 419 + 0.5 × $111 935 + 2.3 × $111 712 + 2.6 × $114 776 + 5.1 × $133 522 + 3.8 × $12 703 + 6.2 × $11 035 + 3.5 × $14 708 + 0.7 × $39 679 = $3 490 000. This number is slightly different from the number reported in Table 3 in the main text ($3 519 000), which also includes the costs for diagnosis of colorectal cancer ($29 000).