Table 1 Base-case estimates and ranges used in sensitivity analysis
Variable | Base-Case Values (Range) | Reference |
|---|---|---|
The disease natural history and prognosis | ||
   Prevalence of colorectal neoplasm at age 50 years | ||
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 (λ 1(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 (λ 2) | 0.0346 (0.0173–0.0692) | 2–4, 17, 21* |
   Large adenoma to preclinical early CRC (λ 3) | 0.0215 (0.0108–0.0430) | 2–4, 17, 21* |
   Preclinical early CRC to preclinical late CRC (λ 4) | 0.3697 (0.2678–0.4715) | 22 |
   Preclinical early CRC to clinical early CRC (λ 5) | 0.2382 (0.2055–0.2709) | 22 |
   Preclinical late CRC to clinical late CRC (λ 6) | 0.4852 (0.3207–0.6498) | 22 |
   Early CRC to CRC death (λ 7) | 0.0302 (0.0151–0.0604) | 2–4, 23 |
   Late CRC to CRC death (λ 8) | 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) |  |