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Table 1 Model parameters and assumptions

From: Cost-effectiveness of colorectal cancer screening in Ukraine

  Base case Range (SD) References
Natural history
 Prevalence of low risk polyp (based on age) At age 50, 0.2 0.15–0.25 [15,16,17]
At age 60, 0.4 0.35–0.45
At age 70, 0.5 0.45–0.55
 Prevalence of high risk polyp (based on age) At age 50, 0.05 0.03–0.07 [15,16,17]
At age 60, 0.09 0.07–0.12
At age 70, 0.16 0.14–0.18
At age 80, 0.21 0.20–0.22
 Prevalence of preclinical early CRC at age 50 0.0024 0.002–0.0026 [15,16,17]
 Prevalence of preclinical regional CRC at age 50 0.0012 0.0008–0.0014 [15,16,17]
 Prevalence of preclinical distant CRC at age 50 0.0004 0.0003–0.0005 [15,16,17]
Yearly transition probabilities
 Normal mucosa to low risk polyp (based on age) At age 50, 0.00836 ± 10% [15,16,17]
At age 55, 0.0099
At age 60, 0.01156
At age 65, 0.0133
At age 70, 0.01521
 Low risk polyp to high risk polyp 0.036 0.025–0.047 [15,16,17]
 High risk polyp to preclinical local cancer 0.042 0.03–0.051 [15,16,17]
 Preclinical local cancer to preclinical regional cancer 0.17 0.12–0.22 [15,16,17]
 Preclinical regional to preclinical distal 0.10 0.05–0.15 [15,16,17,18]
 Preclinical local to clinical local 0.17 0.12–0.23 [15,16,17,18]
 Preclinical regional to clinical regional 0.21 0.16–0.26 [15,16,17,18]
 Preclinical distant to clinical distal 1 N/A [15,16,17,18]
Cancer mortality 5 year standard adherence
 Localized 0.1 N/A [19]
 Regional 0.35 N/A [19]
 Disseminated 0.92 N/A [19]
Adherence with screening guidelines
 FOBT 0.75 0.4–0.8 [20,21,22]
 Sigmoidoscopy with FOBT 0.75 0.4–0.8 [20,21,22]
 Colonoscopy 0.8 0.4–0.8 [20,21,22]
 Colonoscopy after positive screening test 0.84 0.4–0.9 [20,21,22]
Test characteristics
 FOBT sensitivity low risk polyp 0.03 0.01–0.1 [23, 24]
 FOBT sensitivity high risk polyp 0.34 0.2–0.5 [23, 24]
 FOBT sensitivity cancer 0.72 0.5–0.85 [23, 24]
 FOBT specificity 0.91 0.7–0.96 [23, 24]
 Colonoscopy/sigmoidoscopy sensitivity low risk polyp 0.92 0.75–0.95 [25,26,27,28]
 Colonoscopy/sigmoidoscopy sensitivity high risk polyp 0.97 0.75–0.97 [25,26,27,28]
 Colonoscopy/sigmoidoscopy sensitivity cancer 0.93 0.75–0.95 [25,26,27,28]
 Colonoscopy/sigmoidoscopy specificity 1 N/A [25,26,27,28]
 Probability of negative sigmoidoscopy and proximal neoplasm 0.21 0.11–0.31 [25,26,27,28]
Complications
 Death from colonoscopic perforation 0.012 0.01–0.02 [30]
 Perforation from diagnostic colonoscopy 0.0008 0.0006–0.005 [30]
QALY
 Local/regional cancer 0.7 0.52–0.9 [31]
 Disseminated cancer 0.25 0.15–0.35 [31]
Costs (US $)
 Cost of colonoscopy 100 30–300 Expert opinion
 Cost of FOBT 8 5–20 Manufacturer price
 Cost of sigmoidoscopy 20 10–100 Expert opinion
 Cost of treating colonoscopic perforation 500 200–1000 Expert opinion
 Cost of local cancer treatment 500 200–1500 Expert opinion
 Cost of regional cancer treatment 9000 500–15,000 [32]
 Cost of disseminated cancer treatment 20,000 5000–25,000 [32]
 Cost of surveillance 200 100–500 Expert opinion
  1. CRC colorectal cancer, FOBT fecal occult blood test, QALY quality adjusted life years