Table 1.
Parameter | Base case value | Reference | |
Sensitivity and specificity of screening and diagnosis | Sensitivity of FOBT for polyps/cancer | 0.1/0.5 | [15], [28], [29], [30] |
Sensitivity of colonoscopy for polyps/cancer | 0.85/0.97 | [2], [31], [32] | |
Sensitivity of colon study for polyps/cancer | 0.5/0.8 | [2], [33], [34] | |
Sensitivity of sigmoidoscopy for polyps/cancer | 0.67 | [1], [2], [31], [32] | |
Specificity of FOBT | 0.9 | [15], [28], [29], [30] | |
Specificity of colonoscopy | 1 | [2], [31], [32] | |
Specificity of colon study | 0.9 | [2], [33], [34] | |
Specificity of sigmoidoscopy | 1 | [2], [31], [32] | |
Natural history of polyp/cancer sequence | Prevalence of polyps at age 50 | 0.25 | [13], [36] |
Annual polyp incidence rate | 0.005 | [13], [36] | |
Percent of cancers originating as polyps | 100% | [37], [38] | |
Annual cancer incidence of polyp whose duration is below 5 yr | 0.005 | [17], [39], [40], [41] | |
Annual cancer incidence of polyp whose duration is from 5 to 10 yr | 0.01 | [17], [39], [40], [41] | |
Annual cancer incidence of polyp whose duration is above 10 yr | 0.016 | [17], [39], [40], [41] | |
Dwelling time of cancer in early stages | 2 yr | [29], [42] | |
Percent of cancers detected in early stages with no screening | 5% | [21] | |
Five-year all cause survival for early cancer | 90% | [21], [20] | |
Five-year all cause survival for advanced cancer | 54% | [20], [21], [23] | |
Polyp recurrence rate after polypectomy in the first year | 0.11 | [2], [3] | |
Polyp recurrence rate after polypectomy thereafter | 0.03 | [2], [3] | |
Complications and unintended consequences | Rate of perforation of colon in colonoscopy | 0.002 | [12], [13] |
Rate of perforation of colon in polypectomy | 0.004 | [12], [13] | |
Rate of perforation from sigmoidoscopy | 0.0001 | [12], [13] | |
Rate of perforation from colon study | 0.00005 | [7] | |
Death rate from perforated colon | 0.002 | [16], [17] | |
Cost (won1) | Sigmoidoscopy | 26620 | [24] |
Colonoscopy | 52560 | [24] | |
Colon study | 58600 | [24] | |
FOBT | 2290 | [24] | |
Polypectomy | 134600 | [24] | |
Biopsy | 24160 | [24] | |
Treatment of early cancer for first year | 5150000 | [3], [17], [23] | |
Treatment of advanced cancer for first year | 10300000 | [3], [17], [23] | |
Treatment of cancer after first year | 2164000 | [3], [17], [23] | |
Treatment of colonic perforation | 3000000 | [3] |
Exchange rate: 1200 Korean won for one US dollar.