Affiliation:
1. Jockey Club School of Public Health and Primary Care, Faculty of Medicine Chinese University of Hong Kong Hong Kong China
2. Centre for Health Education and Health Promotion, Faculty of Medicine Chinese University of Hong Kong Hong Kong China
3. School of Public Health Chinese Academy of Medical Sciences and the Peking Union Medical College Beijing China
4. School of Public Health Peking University Beijing China
Abstract
AbstractBackground and AimWe aimed to evaluate the cost‐effectiveness of different colonoscopy intervals among average‐risk (5 vs 10 years) and high‐risk (1 vs 3 years) southern Chinese populations.MethodsWe constructed a Markov model with a hypothetical population of 100 000 individuals aged 50–85 years. Average risk was defined as 1–2 non‐advanced adenomas (tubular adenoma sized < 10 mm without high‐grade dysplasia). High risk was defined as ≥ 3 non‐advanced adenomas or any advanced adenoma (adenoma sized ≥ 10 mm, with high‐grade dysplasia, or with villous/tubulovillous histology). Three strategies were compared: a 5/1 strategy (average‐risk subjects: 5‐year interval; high‐risk subjects: 1‐year interval), a 10/3 strategy, and a control strategy (a 10/10 strategy). Costs (US dollar), quality‐adjusted‐life‐years, incremental cost‐effectiveness ratio, and net health benefit were calculated. If the incremental cost‐effectiveness ratio of one strategy against another was less than willingness‐to‐pay ($24 302 US/quality‐adjusted‐life‐years), the strategy was more cost‐effective than another.ResultsCompared with the 10/3 strategy, the 5/1 strategy involved more costs and effects (incremental cost‐effectiveness ratio = $40 044 US/quality‐adjusted life‐years). When the 10/10 strategy was regarded as the control, the 5/1 strategy had a higher incremental cost‐effectiveness ratio than the 10/3 strategy ($26 056 vs $10 344 US/quality‐adjusted life‐years). Furthermore, the 10/3 strategy had the highest net health benefit.ConclusionsA 10/3 interval was more cost‐effective than a 5/1 interval. From an economic perspective, our findings supported a 10‐year interval for average‐risk individuals and a 3‐year interval for high‐risk subjects. The findings could help form the optimal colonoscopy interval for average‐risk and high‐risk patients.
Funder
Health and Medical Research Fund
Subject
Gastroenterology,Hepatology