Table 1.
Parameter | Base Case Value | Range Examined | Reference |
---|---|---|---|
Natural History | |||
Incidence of precancer | 0.008 | 0.002–0.02 | 12,15,16,18 |
Probability of spontaneous regression of precancerous lesion at 7 years | 0.3 | 0.1–0.5 | 17 |
Probability of regression of precancer upon treatment and counseling | 0.28 | 0.1–0.8 | 35 |
Probability of developing Stage I/II cancer from precancer | 0.008 | 0.006–0.05 | 12,17,18,38 |
Probability of developing Stage III/IV cancer from undiagnosed Stage I/II cancer | 0.5 | 0.25–0.75 | Assumption |
Treatment, Recurrence and Survival | |||
Probability of occult neck disease found on neck dissection for Stage I/II treatment | 0.25 | 0.06–0.46 | 21 |
5 year local control failure rate for Stage I/II disease | 0.42** | 0.3–0.5 | 22 |
5 year local control failure rate for Stage III/IV disease | 0.67** | 0.5–0.8 | 3,22,24 |
Probability of Stage I/II presenting with local cancer recurrence | 0.18 | 0.1–0.3 | 23 |
5 year survival for Stage I/II | 0.80** | 0.6–0.9 | 3 |
5 year survival for Stage III/IV | 0.46** | 0.3–0.6 | 3 |
5 year survival for Stage I/II recurrence | 0.46** | 0.3–0.6 | 25 |
2 year survival for Stage III/IV recurrence | 0.16** | 0.05–0.25 | 25 |
Screening and Compliance | |||
Sensitivity of oral exam | 0.74 | 0.6–0.9 | 27 |
Specificity of oral exam | 0.99 | 0.95–0.99 | 5,27 |
Probability of oral exam among healthy and precancer patients – No Screen | 0.13 | 0.05–0.25 | 2 |
Probability of oral exam among healthy and precancer patients – Screen | 0.5 | 0.1–0.9 | Assumption |
Probability of oral exam among patients with undiagnosed Stage I/II cancer | 0.6 | 0.2–0.9 | Assumption |
Probability of oral exam among patients with undiagnosed Stage III/IV cancer | 0.9 | 0.6–0.9 | Assumption |
Probability of compliance with biopsy – No Screen | 0.67 | 0.39–1 | 5,8,9 |
Probability of compliance with biopsy – Screen | 0.8 | 0.5–1 | Assumption |
All probabilities are based on a 1-year cycle unless otherwise noted
Yearly rates derived from probability using Declining Exponential Approximation of Life Expectancy (DEALE)