Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study
Background: The current community-based colorectal cancer (CRC) screening program in Shanghai, launched in 2013, invited individuals aged 50–74 years to triennial screening with a qualitative faecal immunochemical test (FIT) and questionnaire-based risk assessment (RA). We aimed to evaluate the effe...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-10-01
|
| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221133552200198X |
| _version_ | 1811267059818954752 |
|---|---|
| author | Jie Wang Lucie de Jonge Dayna R. Cenin Pei Li Sha Tao Chen Yang Bei Yan Iris Lansdorp-Vogelaar |
| author_facet | Jie Wang Lucie de Jonge Dayna R. Cenin Pei Li Sha Tao Chen Yang Bei Yan Iris Lansdorp-Vogelaar |
| author_sort | Jie Wang |
| collection | DOAJ |
| description | Background: The current community-based colorectal cancer (CRC) screening program in Shanghai, launched in 2013, invited individuals aged 50–74 years to triennial screening with a qualitative faecal immunochemical test (FIT) and questionnaire-based risk assessment (RA). We aimed to evaluate the effectiveness and cost-effectiveness of the existing Shanghai screening program and compare it to using a validated two-sample quantitative FIT. Methods: We simulated four strategies (no screening, Shanghai FIT, Shanghai FIT + RA and validated FIT) for the Shanghai screening program and evaluated CRC incidence, CRC mortality, the number of life years gained (LYG), the number of FITs, and colonoscopies required for each. An incremental cost-effectiveness analysis was performed to assess the cost- effectiveness of each strategy. Results: All screening modalities reduced CRC incidence and CRC mortality, gained extra number of LYG compared to no screening. Screening using the Shanghai FIT and validated FIT reduced CRC incidence from 45 cases to 43 per 1,000 simulated individuals (4.4%). Incidence was reduced to 42 cases (6.7%) using the Shanghai FIT + RA. All screening strategies reduced CRC mortality by 10.0% (from 10 to 9 deaths) and resulted in 6 to 7 LYG. The validated FIT was the most cost-effective among the evaluated strategies (ICER ¥26,461 per LYG). Conclusions: Our findings show that the current Shanghai screening program is (cost-) effective compared to no screening, but changing to a validated FIT would make the program more efficient. |
| first_indexed | 2024-04-12T20:54:30Z |
| format | Article |
| id | doaj.art-3bba33577f994ed3aaefb1fbb037b053 |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-04-12T20:54:30Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-3bba33577f994ed3aaefb1fbb037b0532022-12-22T03:17:01ZengElsevierPreventive Medicine Reports2211-33552022-10-0129101891Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling studyJie Wang0Lucie de Jonge1Dayna R. Cenin2Pei Li3Sha Tao4Chen Yang5Bei Yan6Iris Lansdorp-Vogelaar7Department of Preventive Medicine and Health Education, School of Public Health, Fudan Health Communication Institute, Fudan University, Shanghai, ChinaErasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The NetherlandsErasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands; Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, AustraliaThe Center for Disease Prevention and Control Huangpu, Shanghai, ChinaDepartment of Preventive Medicine and Health Education, School of Public Health, Fudan Health Communication Institute, Fudan University, Shanghai, ChinaShanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, ChinaShanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China; Xi’an International Medical Center Hospital, Xi’an, China; Corresponding author at: No. 777 Xitai Road, Xi'an High Tech Area, Xi'an City, Shanxi Province, China.Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The NetherlandsBackground: The current community-based colorectal cancer (CRC) screening program in Shanghai, launched in 2013, invited individuals aged 50–74 years to triennial screening with a qualitative faecal immunochemical test (FIT) and questionnaire-based risk assessment (RA). We aimed to evaluate the effectiveness and cost-effectiveness of the existing Shanghai screening program and compare it to using a validated two-sample quantitative FIT. Methods: We simulated four strategies (no screening, Shanghai FIT, Shanghai FIT + RA and validated FIT) for the Shanghai screening program and evaluated CRC incidence, CRC mortality, the number of life years gained (LYG), the number of FITs, and colonoscopies required for each. An incremental cost-effectiveness analysis was performed to assess the cost- effectiveness of each strategy. Results: All screening modalities reduced CRC incidence and CRC mortality, gained extra number of LYG compared to no screening. Screening using the Shanghai FIT and validated FIT reduced CRC incidence from 45 cases to 43 per 1,000 simulated individuals (4.4%). Incidence was reduced to 42 cases (6.7%) using the Shanghai FIT + RA. All screening strategies reduced CRC mortality by 10.0% (from 10 to 9 deaths) and resulted in 6 to 7 LYG. The validated FIT was the most cost-effective among the evaluated strategies (ICER ¥26,461 per LYG). Conclusions: Our findings show that the current Shanghai screening program is (cost-) effective compared to no screening, but changing to a validated FIT would make the program more efficient.http://www.sciencedirect.com/science/article/pii/S221133552200198XColorectal cancerScreeningCost-effectivenessFaecal immunochemical testRisk assessmentChina |
| spellingShingle | Jie Wang Lucie de Jonge Dayna R. Cenin Pei Li Sha Tao Chen Yang Bei Yan Iris Lansdorp-Vogelaar Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study Preventive Medicine Reports Colorectal cancer Screening Cost-effectiveness Faecal immunochemical test Risk assessment China |
| title | Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study |
| title_full | Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study |
| title_fullStr | Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study |
| title_full_unstemmed | Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study |
| title_short | Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study |
| title_sort | cost effectiveness analysis of colorectal cancer screening in shanghai china a modelling study |
| topic | Colorectal cancer Screening Cost-effectiveness Faecal immunochemical test Risk assessment China |
| url | http://www.sciencedirect.com/science/article/pii/S221133552200198X |
| work_keys_str_mv | AT jiewang costeffectivenessanalysisofcolorectalcancerscreeninginshanghaichinaamodellingstudy AT luciedejonge costeffectivenessanalysisofcolorectalcancerscreeninginshanghaichinaamodellingstudy AT daynarcenin costeffectivenessanalysisofcolorectalcancerscreeninginshanghaichinaamodellingstudy AT peili costeffectivenessanalysisofcolorectalcancerscreeninginshanghaichinaamodellingstudy AT shatao costeffectivenessanalysisofcolorectalcancerscreeninginshanghaichinaamodellingstudy AT chenyang costeffectivenessanalysisofcolorectalcancerscreeninginshanghaichinaamodellingstudy AT beiyan costeffectivenessanalysisofcolorectalcancerscreeninginshanghaichinaamodellingstudy AT irislansdorpvogelaar costeffectivenessanalysisofcolorectalcancerscreeninginshanghaichinaamodellingstudy |