Table 3.
Comparison of two risk-category-specific screening intervals with the uniform 5-year screening interval
| 5-5-5 screening interval* | 10-5-2 screening interval* | 7-4-1 screening interval* | ||
|---|---|---|---|---|
| Number of people at low or intermediate risk at baseline (per 1 000 000) | 12·4 | 12·4 | 12·4 | |
| Number of person-years spent unidentified in high-risk category (per 1000) | 785 (713 to 863) | 512 (469 to 559) | 282 (254 to 313) | |
| Difference in person-years spent unidentified in high-risk category (per 1000) | 0 (reference) | −273 (−303 to −245) | −503 (−550 to −495) | |
| Number of major cardiovascular events prevented | 0 (reference) | 2730 (2447 to 3033) | 5034 (4592 to 5503) | |
| Number of adverse events | ||||
| Diabetes | 0 (reference) | 410 (367 to 455) | 755 (689 to 825) | |
| Haemorrhagic stroke | 0 (reference) | 41 (37 to 46) | 76 (69 to 83) | |
| Myopathy | 0 (reference) | 27 (24 to 30) | 50 (46 to 55) | |
| Number of QALYs gained | 0 (reference) | 2475 (2219 to 2750) | 4564 (4163 to 4635) | |
| Costs (millions, £)† | ||||
| Health-check costs | 41·3 (40·5 to 42·1) | 39·1 (37·9 to 40·3) | 63·9 (60·8 to 67·2) | |
| Costs saved due to earlier prevention with statin | 0 (reference) | −12·9 (−14·4 to −11·6) | −23·8 (−26·0 to −21·7) | |
| Total costs (health-check costs − savings) | 41·3 (40·5 to 42·1) | 26·2 (26·0 to 26·3) | 40·0 (39·1 to 41·2) | |
| Total costs compared with 5-5-5 screening interval | 0 (reference) | −15·1 (−16·1 to −14·2) | −1·2 (−1·4 to −0·9) | |
Figures are estimated for 1 year. QALY=quality-adjusted life-year.
In years for low-risk, intermediate-low-risk, and intermediate-high-risk individuals (95% CI).
In the population of England and Wales aged 40–64 years.22 Cost of £18·39 per health check derived from Kypridemos and colleagues19 and costs and QALYs gained with preventive statin treatment (£47·33 and 0·00906 QALYs gained per person-year under statin treatment compared with placebo) derived from Collins and colleagues20 and from the West of Scotland Coronary Prevention Study.21 The number of adverse events based on incidence estimates of 0·0015, 0·00015, and 0·00010 for diabetes, haemorrhagic stroke, and myopathy20 among those who would have received statin treatment.