Table 3.
Results under Base Case and Cost Model B. Stage shift effect was excluded.
| Strategy | Comparative Effectiveness | Costs | Cost Effectiveness | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Discounted LY | CRC Diagnosed | CRC Prevented | CRC Risk Reduction | CRC Deaths | Cancer Mortality Risk Reduction | Cancer Management | Screening | Total | Incremental Costs | Incremental Effect | ICER | Status (Rank) | ||||||
| No Screening (Referent Strategy) | 15.199 | 4,483 | 0 | 0% | 1,380 | 0% | $ | 3,494 | $ | – | $ | 3,494 | $ | 463 | −0.022 | $ | (−) | AD |
| ST 1: FOBT | 15.209 | 4,093 | 398 | 9% | 1,167 | 15% | $ | 3,258 | $ | 16 | $ | 3,274 | $ | 243 | −0.012 | $ | (−) | AD |
| ST 2: FIT | 15.205 | 4,327 | 161 | 3% | 1,238 | 10% | $ | 3,338 | $ | 100 | $ | 3,438 | $ | 407 | −0.015 | $ | (−) | AD |
| ST 3: FOBT + Flex Sig | 15.210 | 4,017 | 476 | 10% | 1,138 | 18% | $ | 3,217 | $ | 85 | $ | 3,303 | $ | 272 | −0.011 | $ | (−) | AD |
| ST 4: FIT + Flex Sig | 15.207 | 4,231 | 258 | 6% | 1,188 | 14% | $ | 3,256 | $ | 207 | $ | 3,463 | $ | 432 | −0.013 | $ | (−) | AD |
| ST 5: Colonoscopy | 15.221 | 3,453 | 1,052 | 23% | 954 | 31% | $ | 2,504 | $ | 526 | $ | 3,030 | $ | – | 0.000 | $ | 0 | UD (1) |
| ST 6: Flex Sig | 15.210 | 4,055 | 439 | 10% | 1,172 | 15% | $ | 3,104 | $ | 256 | $ | 3,360 | $ | 330 | −0.011 | $ | (−) | AD |
| ST 7: FOBT 2 | 15.210 | 4,132 | 356 | 8% | 1,160 | 16% | $ | 3,234 | $ | 14 | $ | 3,247 | $ | 217 | −0.011 | $ | (−) | AD |
| ST 8: FIT 2 | 15.206 | 4,354 | 131 | 3% | 1,228 | 11% | $ | 3,294 | $ | 74 | $ | 3,368 | $ | 337 | −0.015 | $ | (−) | AD |
| ST 9: FOBT 2 + Flex Sig | 15.210 | 4,098 | 395 | 9% | 1,148 | 17% | $ | 3,213 | $ | 119 | $ | 3,332 | $ | 301 | −0.010 | $ | (−) | AD |
| ST 10: FIT 2 + Flex Sig | 15.208 | 4,256 | 231 | 5% | 1,175 | 15% | $ | 3,233 | $ | 206 | $ | 3,440 | $ | 409 | −0.012 | $ | (−) | AD |
| ST 11: DNA | 15.210 | 4,033 | 460 | 10% | 1,156 | 16% | $ | 3,255 | $ | 1,469 | $ | 4,724 | $ | 1,694 | −0.011 | $ | (−) | AD |
| ST 12: DNA 2 | 15.210 | 4,062 | 426 | 9% | 1,143 | 17% | $ | 3,222 | $ | 1,333 | $ | 4,555 | $ | 1,524 | −0.011 | $ | (−) | AD |
| ST 13: CT Colonography* | 15.217 | 3,622 | 880 | 19% | 1,026 | 26% | $ | 2,766 | $ | 491 | $ | 3,258 | $ | 227 | −0.004 | $ | (−) | AD |
| ST 11: DNA (Sen=1, Ad Sen=0.424)† | 15.212 | 3,832 | 664 | 15% | 1,096 | 21% | $ | 3,082 | $ | 1,469 | $ | 4,551 | $ | 1,521 | −0.009 | $ | (−) | AD |
| ST 11: DNA (Spe=1, Ad Sen=0.424)‡ | 15.209 | 4,004 | 489 | 11% | 1,148 | 17% | $ | 3,032 | $ | 2,654 | $ | 5,686 | $ | 2,656 | −0.012 | $ | (−) | AD |
| ST 11: DNA (Sen=1, Spe=1, Ad Sen=0.424)§ | 15.209 | 4,004 | 489 | 11% | 1,148 | 17% | $ | 3,032 | $ | 2,654 | $ | 5,686 | $ | 2,656 | −0.012 | $ | (−) | AD |
Comparisons of Effectiveness, Costs, and Cost Effectiveness measures.
LY: Life Years. CRC: Colorectal Cancer. ICER: Incremental Cost Effectiveness Ratio. (−) negative value. AD: Absolute Dominance. UD: Undominated. Ad Sen: Adenoma Sensitivity. Sen: CRC Sensitivity. Spe: CRC Specificity.
CT colonography had a reported sensitivity of 80% for detection of adenomas. Therefore, a proportional CRC risk reduction was given to this strategy.
A sensitivity of 100% for CRC and a sensitivity of 42.4% for detection of adenomas was given to DNA test. Results shown for comparison.
A specificity of 100% for CRC and a sensitivity of 42.4% for detection of adenomas was given to DNA test. Results shown for comparison.
A sensitivity and a specificity of 100% for CRC and a sensitivity of 42.4% for detection of adenomas was given to DNA test. Results shown for comparison.