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Article: Cost-effectiveness simulation and analysis of colorectal cancer screening in Hong Kong Chinese population: comparison amongst colonoscopy, guaiac and immunologic fecal occult blood testing
Title | Cost-effectiveness simulation and analysis of colorectal cancer screening in Hong Kong Chinese population: comparison amongst colonoscopy, guaiac and immunologic fecal occult blood testing |
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Authors | |
Keywords | Cost-effectiveness Colorectal cancer Fecal occult blood testing Colonoscopy Mass screening |
Issue Date | 2015 |
Publisher | BioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmccancer/ |
Citation | BMC Cancer, 2015, v. 15, article no. 705, p. 1-12 How to Cite? |
Abstract | Background: 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. Methods: 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. Results: 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 $50,000 per LYs or QALYs gained. Conclusion: The Markov model informed the health policymakers that I-FOBT every year may be the most effective and cost-effective CRC screening strategy among recommended screening strategies, depending on the willingness-to-pay of mass screening for Chinese population. Trial registration: ClinicalTrials.gov Identifier NCT02038283 |
Persistent Identifier | http://hdl.handle.net/10722/221543 |
ISSN | 2023 Impact Factor: 3.4 2023 SCImago Journal Rankings: 1.087 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Wong, CKH | - |
dc.contributor.author | Lam, CLK | - |
dc.contributor.author | Wan, YF | - |
dc.contributor.author | Fong, DYT | - |
dc.date.accessioned | 2015-11-30T03:34:20Z | - |
dc.date.available | 2015-11-30T03:34:20Z | - |
dc.date.issued | 2015 | - |
dc.identifier.citation | BMC Cancer, 2015, v. 15, article no. 705, p. 1-12 | - |
dc.identifier.issn | 1471-2407 | - |
dc.identifier.uri | http://hdl.handle.net/10722/221543 | - |
dc.description.abstract | Background: The aim of this study was to evaluate the cost-effectiveness of CRC screening strategies from the healthcare service provider perspective based on Chinese population. Methods: A Markov model was constructed to compare the cost-effectiveness of recommended screening strategies including annual/biennial guaiac fecal occult blood testing (G-FOBT), annual/biennial immunologic FOBT (I-FOBT), and colonoscopy every 10 years in Chinese aged 50 year over a 25-year period. External validity of model was tested against data retrieved from published randomized controlled trials of G-FOBT. Recourse use data collected from Chinese subjects among staging of colorectal neoplasm were combined with published unit cost data ($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. Results: 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. Conclusion: 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. Trial registration: ClinicalTrials.gov Identifier NCT02038283 | - |
dc.language | eng | - |
dc.publisher | BioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmccancer/ | - |
dc.relation.ispartof | BMC Cancer | - |
dc.rights | BMC Cancer. Copyright © BioMed Central Ltd. | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Cost-effectiveness | - |
dc.subject | Colorectal cancer | - |
dc.subject | Fecal occult blood testing | - |
dc.subject | Colonoscopy | - |
dc.subject | Mass screening | - |
dc.title | Cost-effectiveness simulation and analysis of colorectal cancer screening in Hong Kong Chinese population: comparison amongst colonoscopy, guaiac and immunologic fecal occult blood testing | - |
dc.type | Article | - |
dc.identifier.email | Wong, CKH: carlosho@hku.hk | - |
dc.identifier.email | Lam, CLK: clklam@hku.hk | - |
dc.identifier.email | Wan, YF: yfwan@hku.hk | - |
dc.identifier.email | Fong, DYT: dytfong@hku.hk | - |
dc.identifier.authority | Wong, CKH=rp01931 | - |
dc.identifier.authority | Lam, CLK=rp00350 | - |
dc.identifier.authority | Wan, YF=rp02518 | - |
dc.identifier.authority | Fong, DYT=rp00253 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1186/s12885-015-1730-y | - |
dc.identifier.pmid | 26471036 | - |
dc.identifier.pmcid | PMC4608156 | - |
dc.identifier.scopus | eid_2-s2.0-84944885048 | - |
dc.identifier.hkuros | 256138 | - |
dc.identifier.volume | 15 | - |
dc.identifier.spage | article no. 705, p. 1 | - |
dc.identifier.epage | article no. 705, p. 12 | - |
dc.identifier.isi | WOS:000362865300008 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 1471-2407 | - |