Strategy | MISCAN | SimCRC | CRC-SPIN | ||||||
---|---|---|---|---|---|---|---|---|---|
Discounted Costs ($) | Discounted LYG | ICER ($) | Discounted Costs ($) | Discounted LYG | ICER ($) | Discounted Costs ($) | Discounted LYG | ICER ($) | |
No screening | 2,320,612 | 0.0 | --- | 2,066,811 | 0.0 | d | 1,685,545 | 0 | d |
HII | 2,369,426 | 85.4 | 571 | 1,631,942 | 102.3 | --- | 1,299,145 | 84.1 | --- |
HS | 2,615,292 | 100.2 | 16,605 | 1,742,331 | 124.9 | 4,904 | 1,445,618 | 105.9 | 6,727 |
FIT | 2,688,092 | 99.7 | d | 1,821,510 | 123.6 | d | 1,537,215 | 103.5 | d |
SIGB | 2,725,559 | 89.2 | d | 1,925,847 | 96.7 | d | 1,724,857 | 85.9 | d |
SIG | 2,760,602 | 92.2 | d | 1,935,992 | 104.5 | d | 1,656,998 | 93.2 | d |
HII + SIGB | 2,832,410 | 103.0 | d | 1,847,372 | 127.8 | d | 1,717,055 | 107.0 | d |
HII + SIG | 2,823,342 | 102.9 | d | 1,865,864 | 129.3 | d | 1,674,508 | 109.0 | d |
HS + SIGB | 2,952,372 | 104.8 | 73,336 | 1,974,606 | 133.7 | 26,215 | 1,731,501 | 113.2 | d |
HS + SIG | 2,933,686 | 104.4 | d | 1,997,694 | 134.1 | 54,647 | 1,702,870 | 113.6 | 33,413 |
FIT + SIGB | 3,151,945 | 105.6 | 272,160 | 2,099,318 | 133.9 | d | 1,921,951 | 112.7 | d |
FIT + SIG | 3,058,485 | 105.0 | d | 2,127,049 | 134.4 | 503,405 | 1,859,241 | 113.4 | d |
COL | 3,011,165 | 101.8 | d | 2,090,696 | 132.5 | d | 1,818,835 | 116.7 | d |
CTC DoD 3D 6mm 5ya | 3,685,253 | 100.6 | d | 2,692,564 | 131.4 | d | 2,477,458 | 112.9 | d |
CTC NCTC 2D/3D 6mm 5ya | 3,751,074 | 96.1 | d | 2,752,347 | 126.6 | d | 2,521,670 | 109.9 | d |
--- indicates default strategy (i.e., the least costly and least effective non-dominated strategy).
LYG = life-years gained vs. no screening; ICER = incremental cost-effectiveness ratio; d = dominated.
a. The two CTC strategies are not competing options; they represent a range of estimates of CTC test characteristics. They are shown here together for comparison purposes only. The ICERs are assessed separately using each CTC strategy in turn.
Table A.4.2. Threshold analysis on CT colonography test characteristics: unit cost of CT colonography screening test resulting in equal outcomes compared to other recommended CRC screening strategies for CRC screening beginning at age 50b
CTC outcome | Screening and counting from age 50 | |
---|---|---|
CTC DoD 3D 6mm 5y | CTC NCTC 2D/3D 6mm 5y | |
5-yearly CTC screening | ||
On efficient frontier | 72, 167, 179 | 79, 148, 174 |
Cost-neutral vs. no screening | NT, 182, 230 | 2, 210, 246 |
Equal to highest ACER | 254, 260, 273 | 259, 266, 289 |
Equal to colonoscopy ACER | 216, 234, 240 | 224, 254, 255 |
10-yearly CTC screening | ||
On efficient frontier | 15, 171, 188 | 23, 166, 220c |
Cost-neutral vs. no screening | NT, 308, 356 | 18 339, 363 |
Equal to highest ACER | 338, 388, 435 | 332, 390, 456 |
Equal to colonoscopy ACER | 286, 308, 369 | 288, 374, 404 |
ACER = average cost-effectiveness ratio compared with no screening (calculated using discounted costs and life-years gained).
b. MISCAN values in plain text; SimCRC values in italics; CRC-SPIN values in bold.
c. CTC strategy is on the frontier as the least effective and least costly non-dominated strategy if the cost is at most this amount.