Table 1 |
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|
Base-case estimates and ranges used in sensitivity analysis |
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|
Variable |
Base-Case Values (Range) |
Reference |
|
|
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|
The disease natural history and prognosis |
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|
|
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|
Prevalence of colorectal neoplasm at age 50 years |
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|
Small adenoma |
9.28% (4.64%–18.56%) |
2–4, 17, 21* |
|
Large adenoma |
3.82% (0.96%–7.64%) |
2–4, 17, 21* |
|
Preclinical early CRC |
0.12% (0.06%–0.24%) |
2–4, 17, 21* |
|
Preclinical late CRC |
0.08% (0.04%–0.16%) |
2–4, 17, 21* |
|
|
||
|
Annual transition rates |
||
|
Normal to small adenoma (λ1(t)) |
||
|
at age 50 years |
0.00836 (0.00418–0.01672) |
2–4, 17, 21* |
|
at age 55 years |
0.00990 (0.00495–0.01980) |
2–4, 17, 21* |
|
at age 60 years |
0.01156 (0.00578–0.02312) |
2–4, 17, 21* |
|
at age 65 years |
0.01333 (0.00667–0.02666) |
2–4, 17, 21* |
|
at age 70 years |
0.01521 (0.00761–0.03042) |
2–4, 17, 21* |
|
Small adenoma to large adenoma (λ2) |
0.0346 (0.0173–0.0692) |
2–4, 17, 21* |
|
Large adenoma to preclinical early CRC (λ3) |
0.0215 (0.0108–0.0430) |
2–4, 17, 21* |
|
Preclinical early CRC to preclinical late CRC (λ4) |
0.3697 (0.2678–0.4715) |
22 |
|
Preclinical early CRC to clinical early CRC (λ5) |
0.2382 (0.2055–0.2709) |
22 |
|
Preclinical late CRC to clinical late CRC (λ6) |
0.4852 (0.3207–0.6498) |
22 |
|
Early CRC to CRC death (λ7) |
0.0302 (0.0151–0.0604) |
2–4, 23 |
|
Late CRC to CRC death (λ8) |
0.2099 (0.1050–0.4198) |
2–4, 23 |
|
|
||
|
Screening and diagnostic test characteristics |
||
|
|
||
|
Flexible sigmoidoscopy reach |
50 (50–60) |
25 |
|
|
||
|
Sensitivity, % |
||
|
Stool DNA testing |
||
|
Small adenoma |
8 (5–75) |
16 |
|
Large adenoma |
15 (12–82) |
10–12, 16 |
|
Preclinical CRC |
52 (50–100) |
10–12, 16 |
|
|
||
|
FOBT |
||
|
Small adenoma |
5 (2–10) |
26–31 |
|
Large adenoma |
10 (5–20) |
26–31 |
|
Preclinical CRC |
50 (13–90) |
26–31 |
|
|
||
|
Flexible sigmoidoscopy and colonoscopy |
||
|
Small adenoma |
78.5 (73–84) |
25 |
|
Large adenoma |
85 (85–90) |
25 |
|
Preclinical CRC |
95 (90–100) |
25, 32–38 |
|
|
||
|
Specificity, % |
||
|
|
||
|
Stool DNA testing |
94 (89–100) |
10–12, 16 |
|
FOBT |
97.5 (95–100) |
2–4 |
|
Flexible sigmoidoscopy |
94 (92–96) |
25 |
|
Colonoscopy |
98 (96–100) |
25 |
|
|
||
|
Complication of colonoscopy |
||
|
|
||
|
Perforation rate, % |
0.2 (0.07–0.85) |
39–40 |
|
Death rate due to perforation, per 100,000 |
10 (0–50) |
39–40 |
|
|
||
|
Costs, $ |
||
|
|
||
|
Screening |
||
|
Stool DNA testing |
44.1 (22.1–88.2) |
Expert opinion |
|
FOBT |
0.6 (0.3–1.2) |
BNHI |
|
Flexible sigmoidoscopy |
35.3 (17.6–70.6) |
BNHI |
|
Colonoscopy |
66.2 (33.1–161.8) |
BNHI |
|
|
||
|
Treatment and confirmation |
||
|
Pathological examination |
20.6 (10.3–41.2) |
BNHI |
|
Biopsy |
13.2 (6.6–26.5) |
BNHI |
|
Colonoscopy |
66.2 (33.1–161.8) |
BNHI |
|
Polypectomy |
42.4 (21.2–84.7) |
BNHI |
|
Initial cost for early CRC |
3117.6 (1558.8–6235.3) |
BNHI |
|
Initial cost for late CRC |
7705.9 (3852.9–15411.8) |
BNHI |
|
Continuing cost for CRC |
176.5 (88.2–352.9) |
BNHI |
|
Terminal Care for CRC |
7647.1 (3823.5–15294.1) |
BNHI |
|
Complication cost for perforation |
1617.6 (808.8–3235.3) |
BNHI |
|
Complication cost for death |
2735.3 (1367.6–5470.6) |
BNHI |
|
|
||
|
Discount rate, % |
3 (0–7) |
|
|
|
||
|
Abbreviations: CRC, colorectal cancer; FOBT, fecal occult blood testing; BNHI, Bureau of National Health Insurance. * The estimates were obtained and re-estimated by combining several data sources [2–4, 17, 21]. |
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|
Wu et al. BMC Cancer 2006 6:136 doi:10.1186/1471-2407-6-136 |
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