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Cost-effectiveness simulation and analysis of colorectal cancer screening in Hong Kong Chinese population: comparison amongst colonoscopy, guaiac and immunologic fecal occult blood testing.
- Source :
- BMC Cancer; 2015, Vol. 15 Issue 1, p705-705, 1p
- Publication Year :
- 2015
-
Abstract
- <bold>Background: </bold>The aim of this study was to evaluate the cost-effectiveness of CRC screening strategies from the healthcare service provider perspective based on Chinese population.<bold>Methods: </bold>A Markov model was constructed to compare the cost-effectiveness of recommended screening strategies including annual/biennial guaiac fecal occult blood testing (G-FOBT), annual/biennial immunologic FOBT (I-FOBT), and colonoscopy every 10 years in Chinese aged 50 year over a 25-year period. External validity of model was tested against data retrieved from published randomized controlled trials of G-FOBT. Recourse use data collected from Chinese subjects among staging of colorectal neoplasm were combined with published unit cost data ($USD in 2009 price values) to estimate a stage-specific cost per patient. Quality-adjusted life-years (QALYs) were quantified based on the stage duration and SF-6D preference-based value of each stage. The cost-effectiveness outcome was the incremental cost-effectiveness ratio (ICER) represented by costs per life-years (LY) and costs per QALYs gained.<bold>Results: </bold>In base-case scenario, the non-dominated strategies were annual and biennial I-FOBT. Compared with no screening, the ICER presented $20,542/LYs and $3155/QALYs gained for annual I-FOBT, and $19,838/LYs gained and $2976/QALYs gained for biennial I-FOBT. The optimal screening strategy was annual I-FOBT that attained the highest ICER at the threshold of $50,000 per LYs or QALYs gained.<bold>Conclusion: </bold>The Markov model informed the health policymakers that I-FOBT every year may be the most effective and cost-effective CRC screening strategy among recommended screening strategies, depending on the willingness-to-pay of mass screening for Chinese population.<bold>Trial Registration: </bold>ClinicalTrials.gov Identifier NCT02038283. [ABSTRACT FROM AUTHOR]
- Subjects :
- COLONOSCOPY
COLON tumors
COMPARATIVE studies
COST effectiveness
FECAL occult blood tests
FECES
GUAIAC
RESEARCH methodology
MEDICAL cooperation
MEDICAL screening
RESEARCH
RECTUM tumors
STATISTICAL sampling
EVALUATION research
RANDOMIZED controlled trials
QUALITY-adjusted life years
EARLY detection of cancer
ECONOMICS
DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 14712407
- Volume :
- 15
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 116567244
- Full Text :
- https://doi.org/10.1186/s12885-015-1730-y