Table 3. Case fatality rates, disability weights and stage distribution used for intervention combinations in Peru.
| Intervention |
Case fatality rates*
|
Disability weights**
|
Stage distribution***
|
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Stage I | Stage II | Stage III | Stage IV | Stage I | Stage II | Stage III | Stage IV | % in stage I | % in stage II | % in stage III | % in stage IV | |
| Untreated | 0.021 | 0.065 | 0.156 | 0.311 | 0.086 | 0.097 | 0.104 | 0.375 | 7.0% | 36.4% | 43.5% | 13.0% |
| Treatment only | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 7.0% | 36.4% | 43.5% | 13.0% |
| Treatment only + Trastuzumab in all HER2 positives | 0.006 | 0.038 | 0.086 | 0.247 | 0.086 | 0.097 | 0.104 | 0.154 | 7.0% | 36.4% | 43.5% | 13.0% |
| Current country specific situation (50% coverage), annual opportunistic screening (15%) and free consultation (30%) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.153 | 7.0% | 36.4% | 43.5% | 13.0% |
| Basic Palliative Care (BPC) | 0.006 | 0.040 | 0.093 | 0.275 | 0.0153 | 13.0% | ||||||
| Extended Palliative Care (EPC) | 0.006 | 0.040 | 0.093 | 0.275 | 0.0152 | 13.0% | ||||||
| Basic Awareness Raising (BAR) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 10.2% | 20.1% | 44.8% | 24.8% |
| Mass media Awareness Raising (MAR) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 21.1% | 41.5% | 24.1% | 13.3% |
| Annual CBE screening (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 29.2%-15.8% | 31.2%-16.9% | 30.4%-51.5% | 9.3%-15.8% |
| Biennial CBE screening (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 26.9%-14.0% | 28.8%-14.9% | 33.9%-54.4% | 10.4%-16.7% |
| Triennial CBE screening (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 25.4%-12.8% | 27.2%-13.7% | 36.3%-56.2% | 11.1%-17.2% |
| Annual mammography screening FIXED 60% (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 26.2%-19.7% | 29.7%-22.7% | 33.6%-43.9% | 10.5%-13.7% |
| Biennial mammography screening FIXED 60% (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 25.7%-19.0% | 29.1%-22.0% | 34.4%-44.9% | 10.8%-14.0% |
| Triennial mammography screening FIXED 60% (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 25.2%-18.6% | 28.6%-21.5% | 35.1%-45.7% | 11.0%-14.3% |
| Annual mammography screening FIXED/MOBILE (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 37.4%-26.5% | 40.0%-28.4% | 17.3%-34.5% | 5.3%-10.6% |
| Biennial mammography screening FIXED/MOBILE (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 36.5%-25.4% | 39.0%-27.2% | 18.8%-36.2% | 5.7%-11.1% |
| Triennial mammography screening FIXED/MOBILE (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 35.8%-24.6% | 38.3%-26.4% | 19.9%-37.5% | 6.1%-11.5% |
| Annual CBE/mammography screening MIXED (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 33.6%-22.3% | 36.0%-23.8% | 23.3%-41.3% | 7.1%-12.6% |
| Biennial CBE/mammography screening MIXED (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 32.1%-20.9% | 34.3%-22.3% | 25.7%-43.5% | 7.9%-13.3% | ||||
| Triennial CBE/mammography screening MIXED (age 40-69/40-64/45-64/45-69/50-69/50-64) | 0.006 | 0.040 | 0.093 | 0.275 | 0.086 | 0.097 | 0.104 | 0.154 | 31.0%-19.9% | 33.2%-21.3% | 27.4%-45.0% | 8.4%-13.8% |
Current country specific situation: Current situation in Peru with treatment coverage of 50%, annual opportunistic screening (15%) and free preventive consultations (30%)[12].
* Derived from Bland et al. and stage I and II corrected for the addition of chemotherapy [30]. For trastuzumab CFs were multiplied with 0.66 [31]for eligible patients (eligibility = 12.7% stage I, 12.07%, stage II, 22.0%, stage III, 30.4% stage IV) [64].
** The DW for stage I is equal to the GDB estimate, while for other stages the GBD long term sequel (0,09) was adjusted according to utilities from the literature [7,32,33] and corrected for relapse to stage IV. Relapse rates were derived from Adjuvant Online [65].
*** Present stage distribution is based on INEN public sector [12]. Effects of MAR derived from Devi et al.[37] Effects of screening interventions were based on stage shifts from baseline [17] to the stage distribution in The Netherlands[35]. Stage shifts were adapted by calculating relative differences in detection rates between The Netherlands and Peru[34]. Calculations included age specific incidence, prevalence [7], sojourn time[34], sensitivity [36] and attendance rates (72% in Peru).