Cost‐effectiveness analysis of a community‐based colorectal cancer screening program in Shanghai, China

Li, Xiao Pan; Chen, Hui Min; Lei, Xiao Hong; Dou, Guanshen; Chen, Yi‐Chen; Chen, Li Ping; Zhang, Yao; Zhao, Gen Ming; Zhong, Wei

doi:10.1111/1751-2980.13027

Cited by 3 publications

(2 citation statements)

References 56 publications

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“…This is also currently considered as a general model for the cancer screening program in China. Furthermore, cost‐effectiveness analysis for colorectal cancer screening in Shanghai, China showed that the plan was more favorable for the rural than the urban population, primarily due to the relatively low participation rate in urban areas [ 64 , 65 ]. More and more studies have recently involved the use of circulating tumor DNA methylation profiles for the early screening or diagnosis [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

Cancer situation in China: what does the China cancer map indicate from the first national death survey to the latest cancer registration?

Feng

Qingling

Huang

et al. 2022

Cancer Communications

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Background Over the past four decades, the Chinese government has conducted three surveys on the distribution of causes of death and built cancer registration. In order to shine a new light on better cancer prevention strategies in China, we evaluated the profile of cancer mortality over the forty years and analyzed the policies that have been implemented. Methods We described spatial and temporal changes in both cancer mortality and the ranking of major cancer types in China based on the data collected from three national surveys during 1973‐1975, 1990‐1992, 2004‐2005, and the latest cancer registration data published by National Central Cancer Registry of China. The mortality data were compared after conversion to age‐standardized mortality rates based on the world standard population (Segi's population). The geographical distribution characteristics were explored by marking hot spots of different cancers on the map of China. Results From 1973 to 2016, China witnessed an evident decrease in mortality rate of stomach, esophageal, and cervical cancer, while a gradual increase was recorded in lung, colorectal, and female breast cancer. A slight decrease of mortality rate has been observed in liver cancer since 2004. Lung and liver cancer, however, have become the top two leading causes of cancer death for the last twenty years. From the three national surveys, similar profiles of leading causes of cancer death were observed among both urban and rural areas. Lower mortality rates from esophageal and stomach cancer, however, have been demonstrated in urban than in rural areas. Rural areas had similar mortality rates of the five leading causes of cancer death with the small urban areas in 1973‐1975. Additionally, rural areas in 2016 also had approximate mortality rates of the five leading causes with urban areas in 2004‐2005. Moreover, stomach, esophageal, and liver cancer showed specific geographical distributions. Although mortality rates have decreased at most of the hotspots of these cancers, they were still higher than the national average levels during the same time periods. Conclusions Building up a strong primary public health system especially among rural areas may be one critical step to reduce cancer burden in China.

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Section: Discussionmentioning

confidence: 99%

Cancer situation in China: what does the China cancer map indicate from the first national death survey to the latest cancer registration?

Feng

Qingling

Huang

et al. 2022

Cancer Communications

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show abstract

“…The annual transition probabilities from one status to another were used as the input. For the annual transition probability of CRC, we referred to the value reported by Ren et al 11 and Li et al 12 (from non-advanced adenoma to advanced adenoma, 2%; from advanced adenoma to local cancer: 4.4%; from local to regional cancer, 30% [25–35%]; and from regional to distant cancer, 50% [45–55%]).…”

Section: Methodsmentioning

confidence: 99%

Cost-Utility Analysis for Colorectal Cancer Screening According to the Initiating Age of National Cancer Screening Program in Korea

Bae,

Lee,

Kim

et al. 2024

J Korean Med Sci

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Background This study aimed to identify the most cost-effective strategy for colorectal cancer screening using the fecal immunochemical test (FIT), focusing on screening initiation age in Korea. Methods We designed Markov simulation models targeting individuals aged 40 years or older. Twelve strategies combining screening initiation ages (40, 45, or 50 years old), termination ages (80 or no limit), and intervals (1 or 2 years) were modeled, and the most cost-effective strategy was selected. The robustness of the results was confirmed using one-way and probabilistic sensitivity analyses. Furthermore, the cost-effectiveness of the qualitative and quantitative FIT methods was verified using scenario analysis. Results The 2-year interval strategy with a screening age range of 45–80 years was the most cost-effective (incremental cost-utility ratio = KRW 7,281,646/quality adjusted life years). The most sensitive variables in the results were transition rate from advanced adenoma to local cancer and discount rate. The uncertainty in the model was substantially low. Moreover, strategies starting at the age of 40 years were also cost-effective but considered suboptimal. The scenario analysis showed that there was no significant difference in cost-effectiveness between strategies with various relative screening ratio of quantitative and qualitative method. Conclusion The screening method for advancing the initiation age, as presented in the 2015 revised national screening recommendations, was superior regarding cost-effectiveness. This study provides a new paradigm for the development of a national cancer screening system in Korea, which can be utilized as a scientific basis for economic evaluations.

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Cost-effectiveness analysis of colonoscopy and fecal immunochemical testing for colorectal cancer screening in China

Ren¹,

Zhao²,

Zhou³

et al. 2022

Front. Public Health

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ObjectiveThis study aimed to evaluate the cost-effectiveness of the colorectal cancer screening in China, and that when the screening was implemented in a specific region.MethodsA 13-state Markov model was established to compare four screening protocols, including annual fecal immunochemical testing (FIT1), biennial fecal immunochemical testing (FIT2), electronic colonoscopy every 10 years (e-CSPY10), and electronic colonoscopy every 5 years (e-CSPY5), with no screening from the perspective of Chinese healthcare system. The model simulated the health states of a cohort of 100,000 average-risk individuals aging from 50 to 75. Additionally, scenarios including the implementation in a specific region, starting from 40, and incompletely successful treatment of cancer were also analyzed.ResultsAnnual and biennial FIT could save 8.13USD (US Dollar) and 44.96USD per person, and increase 0.0705QALYs (Quality-Adjusted Life Years) and 0.2341 QALYs compared with no screening, respectively. Annual FIT could decrease costs by 36.81USD per person and increase 0.1637 QALYs in comparison to biennial FIT. The results showed that both annual and biennial FIT for screening were dominant over no screening, and annual FIT was dominant over biennial FIT. The ICER (Incremental Cost-Effectiveness Ratio) for e-CSPY10 were 1183.51USD/QALY and 536.66USD/QALY compared with FIT1 and FIT2. The ICER for e-CSPY5 were 1158.16USD/QALY and 770.85USD/QALY compared with FIT1 and FIT2. And the ICER for e-CSPY5 relative to e-CSPY10 was 358.71USD/QALY. All the ICER values were lower than the economic threshold of 2021 Chinese GDP (Gross Domestic Product) per capita in 2021(12554.42USD).ConclusionsIt is worthwhile to popularize CRC screening in mainland China, as FIT always saving costs and colonoscopy is cost-effective. Regions with high income can take electronic colonoscopy every 10 years, or even every 5 years into consideration when determining the specific strategies.

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Cost‐effectiveness analysis of a community‐based colorectal cancer screening program in Shanghai, China

Cited by 3 publications

References 56 publications

Cancer situation in China: what does the China cancer map indicate from the first national death survey to the latest cancer registration?

Cancer situation in China: what does the China cancer map indicate from the first national death survey to the latest cancer registration?

Cost-Utility Analysis for Colorectal Cancer Screening According to the Initiating Age of National Cancer Screening Program in Korea

Cost-effectiveness analysis of colonoscopy and fecal immunochemical testing for colorectal cancer screening in China

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