One-way sensitivity results for marginal cost-utility analysis
| Scenario | Marginal cost per QALY gained versus no screening | ||||
|---|---|---|---|---|---|
| Biennial FOBT at 50–69 years | Biennial FOBT at 60–69 years | FSIG once at 55 years | FSIG once at 60 years | FSIG 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 | £2364.99 | Dominates | Dominates | Dominates |
| Undiscounted costs and effects | £1161.22 | £975.96 | Dominates | Dominates | Dominates |
| 40% of individuals never participate in | £2949.64 | £2364.99 | – | – | Dominates |
| FOBT screening | |||||
| 60% compliance with follow-up COL | £4015.46 | £3301.71 | Dominates | Dominates | Dominates |
| Doubled CRC treatment costs | £1433.75 | £850.42 | Dominates | Dominates | Dominates |
| 20% lower sensitivity for FOBT and | £4257.3 | £3657.48 | Dominates | Dominates | £426.37 |
| FSIG screening | |||||
| 10% FOBT sensitivity for all adenomas | £1758.42 | £1369.49 | Dominates | Dominates | Dominates |
| 5% FOBT sensitivity for low-risk | £1891.75 | £1362.24 | Dominates | Dominates | Dominates |
| adenomas, 10% FOBT | |||||
| sensitivity for high-risk adenomas | |||||
| Double adenoma recurrence rates | £3203.04 | £2506.07 | Dominates | Dominates | £155.82 |
| following polypectomy | |||||
| Utility for all cancer states = 0.50 | £4351.17 | £4058.72 | Dominates | Dominates | Dominates |
| FSIG cost = COL cost (£188.40) | – | – | Dominates | Dominates | £252.02 |
| Double cost of FOB test | £6519.84 | £5358.51 | – | – | £961.46 |
| Best case scenario for calibrated natural | £551 | £15 | Dominates | Dominates | Dominates |
| history and sensitivity parameters | |||||
| Worst case scenario for calibrated natural | £7992 | £6111 | Dominates | Dominates | £263 |
| history and sensitivity parameters | |||||