Table 2.
Outcomes for the strategies with 3 months’ disruption and 6, 12, and 24 months’ recovery period: 3-month disruption without catch-up, 3-month disruption with non-prioritised catch-up screening at regular FIT threshold and 3-month disruption with prioritised catch-up screening at increased FIT thresholds; outcomes of the strategies with catch-up (both non-prioritised and prioritised) are compared with the strategy without catch-up.
| Length of recovery period | 3-month disruption | |||||||
|---|---|---|---|---|---|---|---|---|
| No catch-up screeninga | Catch-up screening at regular FIT threshold | Catch-up screening at increased FIT threshold | ||||||
| 47 μg Hb/g | 50 μg Hb/g | 55 μg Hb/g | 60 μg Hb/g | 70 μg Hb/g | 80 μg Hb/g | |||
| ASCCA | ||||||||
| Positivity rate | 6 months | 4.7% | 4.7% | 4.5% | 4.3% | 4.0% | 3.5% | 3.1% |
| 12 months | 4.6% | 4.7% | 4.5% | 4.3% | 4.0% | 3.6% | 3.2% | |
| 24 months | 4.6% | 4.6% | 4.5% | 4.2% | 4.0% | 3.5% | 3.2% | |
| Monthly colonoscopy demand during recovery period | 6 months | 4910 | 7401 (151%) | 7198 (147%) | 6842 (139%) | 6448 (131%) | 5755 (117%) | 5232 (107%) |
| 12 months | 4846 | 6103 (126%) | 5925 (122%) | 5633 (116%) | 5309 (110%) | 4738 (98%) | 4309 (89%) | |
| 24 months | 4848 | 5445 (112%) | 5289 (109%) | 5031 (104%) | 4745 (98%) | 4242 (87%) | 3864 (80%) | |
| Cumulative excess CRC cases in 2020-2050 | 6 months | 923 | 21 (2%) | 96 (10%) | 189 (20%) | 272 (29%) | 424 (46%) | 615 (67%) |
| 12 months | 923 | 33 (4%) | 142 (15%) | 303 (33%) | 446 (48%) | 688 (75%) | 995 (108%) | |
| 24 months | 923 | 55 (6%) | 237 (26%) | 517 (56%) | 796 (86%) | 1218 (132%) | 1739 (188%) | |
| Cumulative excess CRC-related deaths in 2020-2050 | 6 months | 446 | 11 (2%) | 39 (9%) | 54 (12%) | 85 (19%) | 157 (35%) | 212 (47%) |
| 12 months | 446 | 17 (4%) | 55 (12%) | 87 (19%) | 141 (32%) | 243 (54%) | 336 (75%) | |
| 24 months | 446 | 27 (6%) | 89 (20%) | 148 (33%) | 260 (58%) | 420 (94%) | 583 (131%) | |
| MISCAN-Colon | ||||||||
| Positivity rate | 6 months | 3.7% | 3.8% | 3.6% | 3.4% | 3.1% | 2.7% | 2.5% |
| 12 months | 3.7% | 3.8% | 3.6% | 3.4% | 3.1% | 2.7% | 2.5% | |
| 24 months | 3.7% | 3.7% | 3.5% | 3.4% | 3.1% | 2.7% | 2.5% | |
| Monthly colonoscopy demand during recovery period | 6 months | 4110 | 6199 (151%) | 5915 (144%) | 5677 (138%) | 5221 (127%) | 4618 (112%) | 4282 (104%) |
| 12 months | 4178 | 5235 (125%) | 4993 (120%) | 4793 (115%) | 4404 (105%) | 3893 (93%) | 3608 (86%) | |
| 24 months | 4195 | 4684 (112%) | 4469 (107%) | 4293 (102%) | 3950 (94%) | 3502 (83%) | 3248 (67%) | |
| Cumulative excess CRC cases in 2020-2050 | 6 months | 416 | -8 (-2%) | 49 (12%) | 84 (20%) | 153 (37%) | 277 (67%) | 332 (80%) |
| 12 months | 416 | -23 (-6%) | 63 (15%) | 152 (36%) | 276 (66%) | 465 (112%) | 527 (127%) | |
| 24 months | 416 | 9 (2%) | 109 (26%) | 267 (64%) | 497 (120%) | 862 (207%) | 963 (232%) | |
| Cumulative excess CRC-related deaths in 2020-2050 | 6 months | 339 | 6 (2%) | 37 (11%) | 45 (13%) | 103 (30%) | 144 (43%) | 193 (57%) |
| 12 months | 339 | -22 (-6%) | 41 (12%) | 92 (27%) | 168 (50%) | 267 (79%) | 320 (94%) | |
| 24 months | 339 | 11 (3%) | 73 (21%) | 177 (52%) | 293 (86%) | 485 (143%) | 564 (166%) | |
| Length of recovery period | 3-month disruption | |||||||
| No catch-up screeninga | Catch-up screening at regular FIT threshold | Catch-up screening at increased FIT threshold | ||||||
| 20 μg Hb/g | 25 μg Hb/g | 30 μg Hb/g | 40 μg Hb/g | 50 μg Hb/g | 60 μg Hb/g | |||
| Policy1-Bowel | ||||||||
| Positivity rate | 6 months | 8.3% | 8.3% | 7.0% | 6.1% | 4.8% | 3.8% | 3.3% |
| 12 months | 8.2% | 8.3% | 7.0% | 6.1% | 4.9% | 4.0% | 3.4% | |
| 24 months | 8.2% | 8.3% | 7.0% | 6.1% | 4.8% | 3.9% | 3.3% | |
| Monthly colonoscopy demand during recovery period | 6 months | 6220 | 9352 (150%) | 8105 (130%) | 7128 (115%) | 5827 (94%) | 4884 (79%) | 4299 (69%) |
| 12 months | 6262 | 7829 (125%) | 6781 (108%) | 5967 (95%) | 4877 (78%) | 4087 (65%) | 3595 (57%) | |
| 24 months | 6263 | 7063 (113%) | 6072 (97%) | 5301 (85%) | 4266 (68%) | 3516 (56%) | 3047 (49%) | |
| Cumulative excess CRC cases in 2020-2050 | 6 months | 1657 | 0 (0%) | 464 (28%) | 649 (39%) | 956 (58%) | 1260 (76%) | 1361 (82%) |
| 12 months | 1657 | 24 (1%) | 843 (51%) | 1213 (73%) | 1750 (106%) | 2207 (133%) | 2558 (154%) | |
| 24 months | 1657 | 34 (2%) | 1310 (79%) | 1985 (120%) | 2944 (179%) | 3656 (221%) | 4391 (265%) | |
| Cumulative excess CRC-related deaths in 2020-2050 | 6 months | 978 | 0 (0%) | 188 (19%) | 225 (23%) | 379 (39%) | 400 (41%) | 517 (53%) |
| 12 months | 978 | 8 (1%) | 322 (33%) | 406 (42%) | 621 (63%) | 739 (76%) | 945 (97%) | |
| 24 months | 978 | 11 (1%) | 474 (48%) | 632 (65%) | 1004 (103%) | 1278 (131%) | 1620 (166%) | |
| OncoSim | ||||||||
| Positivity rate | 6 months | NA | NA | NA | NA | NA | NA | NA |
| 12 months | NA | NA | NA | NA | NA | NA | NA | |
| 24 months | NA | NA | NA | NA | NA | NA | NA | |
| Monthly colonoscopy demand during recovery period | 6 months | 7929 | 11904 (150%) | 10320 (130%) | 8820 (111%) | 7011 (88%) | 5729 (72%) | 4997 (63%) |
| 12 months | 7995 | 9960 (125%) | 8652 (108%) | 7403 (93%) | 5903 (74%) | 4845 (61%) | 4250 (53%) | |
| 24 months | 7995 | 8277 (104%) | 7205 (91%) | 6169 (74%) | 4927 (60%) | 4054 (50%) | 3563 (45%) | |
| Cumulative excess CRC cases in 2020-2050 | 6 months | NA | NA | NA | NA | NA | NA | NA |
| 12 months | NA | NA | NA | NA | NA | NA | NA | |
| 24 months | NA | NA | NA | NA | NA | NA | NA | |
| Cumulative excess CRC-related deaths in 2020-2050 | 6 months | 436 | 51 (12%) | 183 (42%) | 288 (66%) | 493 (113%) | 560 (128%) | 633 (145%) |
| 12 months | 436 | 70 (16%) | 275 (63%) | 433 (99%) | 762 (175%) | 899 (206%) | 1031 (236%) | |
| 24 monthsb | 436 | 27 (6%) | 347 (80%) | 646 (148%) | 1198 (275%) | 1443 (331%) | 1661 (381%) | |
FIT: faecal immunochemical test; CRC: colorectal cancer; µg Hb/g: microgram haemoglobin per gram faeces; NA: not available.
This is only 1 strategy, but the outcomes differed per recovery period, because the recovery periods include different months: the 6-month recovery period runs from July 2020-December 2020, the 12-month from July 2020-June 2021, and the 24-month from July 2020-June 2022.
OncoSim assumed that the 2-year screening interval was maintained in individuals delayed for screening, rather than returning to the original date of screening after the recovery period, which was assumed by the other models.
Note: For the period 2020-2050 without disruption, a total of 403,076 CRC cases and 141,400 CRC-related deaths are predicted with ASCCA, 441,960 CRC cases and 164,851 CRC-related deaths with MISCAN-Colon, 633,152 CRC cases and 204,377 CRC-related deaths with Policy1-Bowel, and 332,850 CRC deaths with OncoSim.