. Author manuscript; available in PMC: 2014 Dec 3.

Published in final edited form as: Ann Intern Med. 2014 Jun 3;160(11):750–759. doi: 10.7326/M13-2263

Appendix Table 5.

CRC Screening Indicated in Elderly Without Prior Screening: Results of Sensitivity Analyses.

NO COMORBIDITY
Analysis	Up to what age should CRC screening be considered?	Which screening strategy is indicated at what age?
		Age
		76	77	78	79	80	81	82	83	84	85	86	87	88	89	90
Base Case	86	COL	COL	COL	COL	COL	COL	COL	COL	SIG	FIT	FIT
Utility loss colonoscopy, sigmoidoscopy, complication^*0.5	86	COL	COL	COL	COL	COL	COL	COL	COL	COL	SIG	FIT
Utility loss colonoscopy, sigmoidoscopy, complication^*2	86	COL	COL	COL	COL	COL	COL	SIG	FIT	FIT	FIT	FIT
Utility loss LYs with continuing care stage I, II CRC = 0.12, 0.18	84	COL	COL	COL	COL	COL	COL	COL	SIG	SIG
Costs of colonoscopy, sigmoidoscopy, FIT^*1.25	86	COL	COL	COL	COL	COL	COL	COL	SIG	FIT	FIT	FIT
Costs of colonoscopy, sigmoidoscopy, FIT^*0.75	86	COL	COL	COL	COL	COL	COL	COL	COL	COL	SIG	FIT
Costs of CRC care^*1.25	86	COL	COL	COL	COL	COL	COL	COL	COL	SIG	FIT	FIT
Costs of CRC care^*0.75	87	COL	COL	COL	COL	COL	COL	COL	COL	SIG	FIT	FIT	FIT
Miss rates colonoscopy, sigmoidoscopy^*2	86	COL	COL	COL	COL	COL	COL	COL	COL	FIT	FIT	FIT
No surveillance in adenoma patients	86	COL	COL	COL	COL	COL	COL	COL	COL	COL	SIG	FIT
CRC risk^*1.25	86	COL	COL	COL	COL	COL	COL	COL	COL	COL	COL	FIT
CRC risk^*0.75	86	COL	COL	COL	COL	COL	SIG	SIG	SIG	FIT	FIT	FIT
2 annual FITs as an additional screening strategy	86	COL	COL	COL	COL	COL	COL	COL	COL	2FITs	2FITs	FIT
Threshold willingness to pay per QALY gained = $50,000	84	COL	COL	COL	COL	COL	SIG	SIG	FIT	FIT

MODERATE COMORBIDITY
Analysis	Up to what age should CRC screening be considered?	Which screening strategy is indicated at what age?
		Age
		76	77	78	79	80	81	82	83	84	85	86	87	88	89	90
Base Case	83	COL	COL	COL	COL	COL	SIG	FIT	FIT
Utility loss colonoscopy, sigmoidoscopy, complication^*0.5	84	COL	COL	COL	COL	COL	COL	SIG	FIT	FIT
Utility loss colonoscopy, sigmoidoscopy, complication^*2	83	COL	COL	COL	SIG	FIT	FIT	FIT	FIT
Utility loss LYs with continuing care stage I, II CRC = 0.12, 0.18	81	COL	COL	COL	COL	SIG	SIG
Costs of colonoscopy, sigmoidoscopy, FIT^*1.25	83	COL	COL	COL	COL	SIG	FIT	FIT	FIT
Costs of colonoscopy, sigmoidoscopy, FIT^*0.75	84	COL	COL	COL	COL	COL	COL	SIG	FIT	FIT
Costs of CRC care^*1.25	83	COL	COL	COL	COL	COL	SIG	FIT	FIT
Costs of CRC care^*0.75	84	COL	COL	COL	COL	COL	SIG	FIT	FIT	FIT
Miss rates colonoscopy, sigmoidoscopy^*2	83	COL	COL	COL	COL	COL	SIG	FIT	FIT
No surveillance in adenoma patients	84	COL	COL	COL	COL	COL	COL	COL	FIT	FIT
CRC risk^*1.25	83	COL	COL	COL	COL	COL	COL	COL	FIT
CRC risk^*0.75	83	COL	COL	SIG	SIG	SIG	FIT	FIT	FIT
2 annual FITs as an additional screening strategy	83	COL	COL	COL	COL	COL	SIG	2FITs	FIT
Threshold willingness to pay per QALY gained = $50,000	80	COL	COL	SIG	SIG	FIT

SEVERE COMORBIDITY
Analysis	Up to what age should CRC screening be considered?	Which screening strategy is indicated at what age?
		Age
		76	77	78	79	80	81	82	83	84	85	86	87	88	89	90
Base Case	80	COL	COL	SIG	FIT	FIT
Utility loss colonoscopy, sigmoidoscopy, complication^*0.5	80	COL	COL	COL	SIG	SIG
Utility loss colonoscopy, sigmoidoscopy, complication^*2	80	SIG	FIT	FIT	FIT	FIT
Utility loss LYs with continuing care stage I, II CRC = 0.12, 0.18	78	COL	SIG	SIG
Costs of colonoscopy, sigmoidoscopy, FIT^*1.25	80	SIG	SIG	FIT	FIT	FIT
Costs of colonoscopy, sigmoidoscopy, FIT^*0.75	80	COL	COL	COL	SIG	SIG
Costs of CRC care^*1.25	80	COL	COL	SIG	SIG	FIT
Costs of CRC care^*0.75	81	COL	COL	SIG	FIT	FIT	FIT
Miss rates colonoscopy, sigmoidoscopy^*2	80	COL	COL	FIT	FIT	FIT
No surveillance in adenoma patients	81	COL	COL	COL	SIG	FIT	FIT
CRC risk^*1.25	80	COL	COL	COL	COL	FIT
CRC risk^*0.75	80	SIG	SIG	FIT	FIT	FIT
2 annual FITs as an additional screening strategy	80	COL	COL	2FITs	2FITs	2FITs
Threshold willingness to pay per QALY gained = $50,000	77	SIG	FIT

CRC = colorectal cancer; LY = life-year; QALY = quality-adjusted life-year; COL = once-only colonoscopy screening; SIG = once-only sigmoidoscopy screening; FIT = once-only fecal immunochemical test screening; 2FITs = fecal immunochemical test screening during two consecutive years

Individuals are classified as having moderate comorbidity if diagnosed with an ulcer, rheumatologic disease, peripheral vascular disease, diabetes, paralysis, or cerebrovascular disease, and in case of a history of acute myocardial infarction; as having severe comorbidity if diagnosed with chronic obstructive pulmonary disease, congestive heart failure, moderate or severe liver disease, chronic renal failure, dementia, cirrhosis and chronic hepatitis or AIDS; and as having no comorbidity if none of these conditions is present.