Table 2.

Conclusions about relative costs and of computed tomographic colonography (CTC) and colonoscopy (COL) and assumptions about test sensitivity, specificity and costs for 10 disease simulation models. Unless noted, sensitivity estimates are per-person and costs are in US dollars.

Study	Sensitivity for Adenoma by Size/Risk								Specificity		Per Exam Cost			Least Costly Screening Program
	1–5 mm/Low-Risk		6–9 mm/Low-Risk		≥10 mm/High-risk		Cancer				COL	COL with polypectomy	CTC
	CTC	COL	CTC	COL	CTC	COL	CTC	COL	CTC	COL
Heitman et al (29)	*	*	0.61	0.94	0.71	0.96	†	†	0.84	1.0	$547I	$668I	$445I	COL
Sonnenberg et al (30)	0.80	0.95	0.80	0.95	0.80	0.95	0.80	0.95	0.94	1.0	$728	$1,139	$478	CTCA
Ladabaum et al (31)	0.70	0.85	0.70	0.85	0.75	0.90	0.95	0.95	0.85	1.0	$820	$1,200	$820	COL
Vijan et al (32)B	0.46	0.85	0.83	0.85	0.91	0.95	‡	‡	0.91	1.0	$653	$831	$559	COL
Hassan et al (33)	0.48	0.80	0.70	0.85	0.85	0.90	0.95	0.95	0.86	0.90	€148.2	€228.6	€100.9	CTC
Lee et al (34)	*	*	0.653	0.924C 0.950D	0.899	0.859 C 0.883D	0.899	0.859C 0.883D	0.88	1.0	£488G	£488G	£128	CTC
Telford et al (35)	0.50E	0.92E	0.50E	0.92E	0.78F	0.97F	0.89	0.93	0.91	1.0	$424I	$609I	$590I	COL
Knudsen et al (7)J	0K	0.75	0.84	0.85	0.92	0.95	0.92	0.95	0.80	0.90	$498H	$649H	$488H	COL

^*Adenomas <6 mm not modeled

^†Not reported, assumed no prevalent colorectal cancer

^‡Not reported

^ACOL screening was more cost-effective than CTC screening

^BCTC was evaluated with both 2- and 3-dimensional reading displays. Sensitivity, specificity and costs shown are for 3-dimensional CTC, which dominated 2-dimensional CTC.

^CAdenomas in the proximal colon

^DAdenomas in the distal colon

^ELow-risk adenomas, without high-risk histology

^FHigh-risk adenomas, includes lesions <10 mm with high-risk histology

^GSeparate costs for COL with and without polypectomy not specified

^HCosts from the perspective of the Centers for Medicare and Medicaid Services

^ICanadian dollars

^JSensitivity estimates are per lesion

^KAnalysis assumed a 6 mm referral threshold for a follow-up colonoscopy, thus the effective sensitivity for 1–5mm adenomas was 0