Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study

Jie Wang; Lucie de Jonge; Dayna R. Cenin; Pei Li; Sha Tao; Chen Yang; Bei Yan; Iris Lansdorp-Vogelaar

doi:10.1016/j.pmedr.2022.101891

Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study

Jie Wang, Lucie de Jonge, Dayna R. Cenin, Pei Li, Sha Tao, Chen Yang, Bei Yan^*, Iris Lansdorp-Vogelaar

^*Corresponding author for this work

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Abstract

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.

Original language	English
Article number	101891
Journal	Preventive Medicine Reports
Volume	29
DOIs	https://doi.org/10.1016/j.pmedr.2022.101891
Publication status	Published - Oct 2022

Bibliographical note

Funding Information:
This study is funded by Research Grant for Health Science and Technology of Pudong Health and Family Planning Commission of Shanghai, China (Grant No.PW2017A-7). This research benefitted from our participation in the National Cancer Institute’s Cancer Intervention and Surveillance Modeling Network (CISNET) (grant number: U01‐CA199335).

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© 2022 The Authors

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Cost-effectiveness analysis of colorectal cancer screening in Shanghai, ChinaFinal published version, 551 KBLicence: CC BY

Cite this

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title = "Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study",

abstract = "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.",

author = "Jie Wang and {de Jonge}, Lucie and Cenin, {Dayna R.} and Pei Li and Sha Tao and Chen Yang and Bei Yan and Iris Lansdorp-Vogelaar",

note = "Funding Information: This study is funded by Research Grant for Health Science and Technology of Pudong Health and Family Planning Commission of Shanghai, China (Grant No.PW2017A-7). This research benefitted from our participation in the National Cancer Institute{\textquoteright}s Cancer Intervention and Surveillance Modeling Network (CISNET) (grant number: U01‐CA199335). Publisher Copyright: {\textcopyright} 2022 The Authors",

year = "2022",

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doi = "10.1016/j.pmedr.2022.101891",

language = "English",

volume = "29",

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T1 - Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China

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AU - Wang, Jie

AU - de Jonge, Lucie

AU - Cenin, Dayna R.

AU - Li, Pei

AU - Tao, Sha

AU - Yang, Chen

AU - Yan, Bei

AU - Lansdorp-Vogelaar, Iris

N1 - Funding Information: This study is funded by Research Grant for Health Science and Technology of Pudong Health and Family Planning Commission of Shanghai, China (Grant No.PW2017A-7). This research benefitted from our participation in the National Cancer Institute’s Cancer Intervention and Surveillance Modeling Network (CISNET) (grant number: U01‐CA199335). Publisher Copyright: © 2022 The Authors

PY - 2022/10

Y1 - 2022/10

N2 - 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.

AB - 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.

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Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study

Abstract

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