Table 4

 One-way sensitivity results for marginal cost-utility analysis

ScenarioMarginal cost per QALY gained versus no screening
Biennial FOBT at 50–69 yearsBiennial FOBT at 60–69 yearsFSIG once at 55 yearsFSIG once at 60 yearsFSIG once at 60 years,biennial FOBT at 61–70 years
COL, colonoscopy; CRC, colorectal cancer; FOBT, faecal occult blood test; FSIG, flexible sigmoidoscopy.
Base case scenario£2949.64£2364.99DominatesDominatesDominates
Undiscounted costs and effects£1161.22£975.96DominatesDominatesDominates
40% of individuals never participate in£2949.64£2364.99Dominates
FOBT screening
60% compliance with follow-up COL£4015.46£3301.71DominatesDominatesDominates
Doubled CRC treatment costs£1433.75£850.42DominatesDominatesDominates
20% lower sensitivity for FOBT and£4257.3£3657.48DominatesDominates£426.37
FSIG screening
10% FOBT sensitivity for all adenomas£1758.42£1369.49DominatesDominatesDominates
5% FOBT sensitivity for low-risk£1891.75£1362.24DominatesDominatesDominates
adenomas, 10% FOBT
sensitivity for high-risk adenomas
Double adenoma recurrence rates£3203.04£2506.07DominatesDominates£155.82
following polypectomy
Utility for all cancer states = 0.50£4351.17£4058.72DominatesDominatesDominates
FSIG cost = COL cost (£188.40)DominatesDominates£252.02
Double cost of FOB test£6519.84£5358.51£961.46
Best case scenario for calibrated natural£551£15DominatesDominatesDominates
history and sensitivity parameters
Worst case scenario for calibrated natural£7992£6111DominatesDominates£263
history and sensitivity parameters