The incremental effectiveness of treating NIDDM with the goal of normoglycemia is estimated to be approximately $16,000/QALY gained, which is in the range of interventions that are generally considered cost-effective.

A probabilistic model of NIDDM predicts the vascular complications of NIDDM in a cohort representative of the incident cases of diabetes in the U.S. before age 75 years. Predictions of complications and mortality are consistent with the known epidemiology of NIDDM. The model is suitable for evaluating the effect of preventive interventions on the natural history of NIDDM.

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Background In 2014 a national campaign was launched to increase colorectal cancer (CRC) screening rates in the U.S. to 80% by 2018; it is unknown if there is sufficient colonoscopy capacity to reach this goal. We estimate the number of colonoscopies needed to screen 80% of the eligible population with fecal immunochemical testing (FIT) or colonoscopy, and if there is sufficient colonoscopy capacity to meet the need. Methods The Microsimulation Screening Analysis-colon (MISCAN-colon) model was used to simulate CRC screening test use in the U.S. (2014–2040), assuming the implementation of a national screening program in 2014 with FIT or colonoscopy with 80% participation. The 2012 Survey of Endoscopic Capacity (SECAP) estimated the number of colonoscopies that were performed and the number that could be performed. Results If a national screening program started in 2014, by 2024, approximately 47 million FITs and 5.1 million colonoscopies would be needed annually to screen the eligible population with a program using FIT as the primary screening test; approximately 11 to 13 million colonoscopies would be needed annually to screen the eligible population with a colonoscopy only screening program. Based on the SECAP survey, an estimated 15 million colonoscopies were performed in 2012 and an additional 10.5 million colonoscopies could be performed. Conclusions The estimated colonoscopy capacity is sufficient to screen 80% of the eligible U.S. population with FIT, colonoscopy, or a mix of tests. Future analyses should take into account the geographic distribution of colonoscopy capacity.

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