Table 4.
(Incremental) Cost-effectiveness of Newly Developed Colorectal Cancer Screening Strategies Compared With no Screening and With Established Tests. Source: Iris Lansdorp-Vogelaar, Amy B. Knudsen and Hermann Brenner. Cost-effectiveness of Colorectal Cancer Screening. Epidemiol Rev (2011) 33 (1): 88-100
| Strategy and Study: First Author, Year (Reference No.)a | Study Details | Comparator Strategies | CERb | ICERb,c | ||
|---|---|---|---|---|---|---|
| FIT | Test Usedd | Sensitivity for Cancer, Specificity | Test Costsb | |||
| Berchi, 2004 (33) | Magstream | Sn: 82 Sp: 96 |
12 | gFOBT | 3,900 | |
| Chen, 2007 (43) | OC-SENSOR | Sn: 64.6-84.6 Sp: 77.1-97.1 |
3 | No screening | CS | Dominant |
| Parekh, 2008 (49) | Insure FIT | Sn: 76 Sp: 91 |
25 | gFOBT, COL, stool DNA test | CS | Dominant |
| Shimbo, 1994 (32) | Reversed passive hemagglutination assay | Sn: 48.1-84.3 Sp: 99 |
13 | gFOBT | 25,900 | Dominant |
| Zauber, 2009 (MISCAN) (22) | Mix of tests | Sn: 70 Sp: 95 |
24 | gFOBT, SENSA, COL, FSIG, CTC, FSIG + gFOBT | 800 | Dominated by SENSA |
| Zauber, 2009 (SimCRC) (22) | Mix of tests | Sn: 70 Sp: 95 |
24 | gFOBT, SENSA, COL, FSIG, CTC, FSIG + gFOBT | CS | Dominated by SENSA |
| Zauber, 2009 (CRC-SPIN) (22) | Mix of tests | Sn: 70 Sp: 95 |
24 | gFOBT, SENSA, COL, FSIG, CTC, FSIG + gFOBT | CS | Dominated by SENSA |
| Stool DNA | Test Usedd | Sensitivity for Cancer, Specificity | Test Costsb | |||
| Leshno, 2003 (39) | PreGen-Plus | Sn: 91 Sp: 90 |
86 | gFOBT, COL, FSIG + gFOBT | 600 | Dominated by COL and FSIG + gFOBT |
| Parekh, 2008 (49) | PreGen-Plus | Sn: 65 Sp: 95 |
879 | gFOBT, COL, FIT | 17,500-23,700 | Dominated by all tests |
| Wu, 2006 (47) | PreGen-Plus | Sn: 52 Sp: 94 |
53 | gFOBT, FSIG, COL | 9,300-11,900 | Dominated by all tests |
| Zauber (MISCAN), 2007 (52) | PreGen-Plus | Sn: 70 Sp: 96 |
375 | gFOBT, SENSA, COL, FSIG, FIT, FSIG + gFOBT | 12,200-23,900 | Dominated by all tests |
| Zauber (SimCRC), 2007 (52) | PreGen-Plus | Sn: 70 Sp: 96 |
375 | gFOBT, SENSA, COL, FSIG, FIT, FSIG + gFOBT | 10,800-31,800 | Dominated by all tests |
| CTC | Follow-up Interval | Sensitivity for Cancer, Specificity | Test Costsb | |||
| Hassan, 2007 (44) | 10 years, all findings | Sn: 95 Sp: 86 |
97 | FSIG, COL | CS | Dominant vs. FSIG, ICER COL vs. CTC: 14,600 |
| Ladabaum, 2004 (53) | 10 years, all findings | Sn: 95 Sp: 85 |
1,037 | COL | 36,300 | Dominated by COL |
| Pickhardt, 2007 (19) | 10 years, findings 6+ mm | Sn: 95 Sp: 86 |
555 | FSIG, COL | 5,100 | Dominant vs. FSIG, ICER COL vs. CTC: 74,200 |
| Sonnenberg, 2000 (54) | 10 years, all findings | Sn: 80 Sp: 95 |
741 | COL | 17,800 | Dominated by COL |
| Vijan, 2007 (23) | 5 years, all findings | Sn: 91 Sp: 91 |
707 | gFOBT, COL, FSIG, FSIG + gFOBT | 10,300-21,800 | 197,200 |
| Zauber, 2009 (MISCAN) (22) | 5 years, findings 6+ mm | Sn: 84-92 Sp: 80-88 |
522 | gFOBT, SENSA, COL, FSIG, FIT, FSIG + gFOBT | 9,500-10,200 | Dominated by COL, FSIG + gFOBT |
| Zauber, 2009 (SimCRC) (22) | 5 years, findings 6+ mm | Sn: 84-92 Sp: 80-88 |
522 | gFOBT, SENSA, COL, FSIG, FIT, FSIG + gFOBT | 3,600-4,200 | Dominated by COL, FSIG + gFOBT |
| Zauber, 2009 (CRC-SPIN) (22) | 5 years, findings 6+ mm | Sn: 84-92 Sp: 80-88 |
522 | gFOBT, SENSA, COL, FSIG, FIT, FSIG + gFOBT | 1,900-2,100 | Dominated by COL, FSIG + gFOBT |
Abbreviations: CER, cost-effectiveness ratio compared with no screening; COL, colonoscopy; CS, cost-saving; CTC, computed tomographic colonography; FIT, fecal immunochemical test; FSIG, flexible sigmoidoscopy; gFOBT, guaiac fecal occult blood test with Hemoccult II (Beckman Coulter, Inc., Brea, California); ICER, incremental cost-effectiveness ratio; SENSA, guaiac fecal occult blood test with Hemoccult SENSA (Beckman Coulter).
a The paper by Zauber et al. (22) contained analyses from 3 independently developed colorectal cancer models: MISCAN, SimCRC, and CRC-SPIN.
b Values are expressed as 2010 US dollars.
c Dominant indicates that the test of interest (i.e., FIT, stool DNA, or CTC) was more effective and less costly than the comparator strategies. Dominated indicates that the test of interest was less effective and more costly than the reported comparator strategies.
d Insure FIT, Enterix Inc., Edison, New Jersey; Magstream, Fujirebio Inc., Tokyo, Japan; OC-SENSOR, Eiken Chemical Co. Ltd., Tokyo, Japan; PreGen-Plus, EXACT Sciences Corporation, Madison, Wisconsin.