Table 1.
Base Case Clinical and Economic Outcomes for Screening From Age 45 vs 50 Years Through Age 75 Years, Including Post-Polypectomy Surveillance ThroughAge 80 Years
Outcomes per 1000 persons ages 45–100 years | |||||||||
---|---|---|---|---|---|---|---|---|---|
Cost effectiveness | |||||||||
Strategy | CRC cases, n | CRC deaths, n | Colonoscopies, n | Stool tests, n | Sigmoidoscopies, n | QALYs per person | Cost per person | Comparator strategy | Cost per QALY gained |
No screening | 106 | 43 | 275 | — | — | 21.1645 | $5146 | — | — |
Screening starting at age 45 years | |||||||||
Colonoscopy every 10 years, ages 45–75 years | 28 | 9 | 4764 | — | — | 21.3098 | $5013 | Colonoscopy every 10 years, ages 50–75 years | $33,900 |
FIT yearly, ages 45–75 years | 42 | 12 | 2194 | 18,253 | — | 21.3073 | $3447 | FIT yearly, ages 50–75 years | $7700 |
Sigmoidoscopy at 45 years; colonoscopy every 10 years, ages 50–75 years | 31 | 10 | 4200 | — | 997 | 21.3047 | $5047 | Colonoscopy every 10 years, ages 50–75 years | $55,900 |
Sigmoidoscopy at 45, FIT yearly 50–75 | 40 | 11 | 2344 | 13,613 | 997 | 21.3056 | $3956 | FIT yearly, ages 50–75 years | $49,900 |
FIT yearly 45–49;colonoscopy every 10 years, ages 50–75 years | 31 | 10 | 4062 | 4521 | — | 21.3033 | $4554 | Colonoscopy every 10 years, ages 50–75 years | $2500 |
Screening starting at age 50 years | |||||||||
Colonoscopy every 10 years, ages 50–75 years | 33 | 10 | 4007 | — | — | 21.2954 | $4526 | No screening | Dominatesa |
FIT yearly, ages 50–75 years | 45 | 13 | 1926 | 15,011 | — | 21.2933 | $3339 | No screening | Dominatesa |
More effective and less costly than comparator. See Supplementary Materials for analysis of colonoscopy vs no screening as a function of CRC risk.