Academic Journal
Long-term evaluation of benefits, harms, and cost-effectiveness of the National Bowel Cancer Screening Program in Australia: A modelling study
| العنوان: | Long-term evaluation of benefits, harms, and cost-effectiveness of the National Bowel Cancer Screening Program in Australia: A modelling study |
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| المؤلفون: | Lew, J.-B. (Jie-Bin), St John, D.J.B. (D James B), Xu, X.-M. (Xiang-Ming), Greuter, M.J.W. (Marcel), Caruana, M. (Michael), Cenin, D.R. (Dayna R.), He, E. (Emily), Saville, M. (Marion), Grogan, P. (Paul), Coupé, V.M.H. (Veerle), Canfell, K. (Karen) |
| المصدر: | The Lancet Public Health |
| سنة النشر: | 2017 |
| المجموعة: | RePub - Publications from Erasmus University, Rotterdam |
| الوصف: | Background: No assessment of the National Bowel Screening Program (NBCSP) in Australia, which considers all downstream benefits, costs, and harms, has been done. We aimed to use a comprehensive natural history model and the most recent information about cancer treatment costs to estimate long-term benefits, costs, and harms of the NBCSP (2 yearly immunochemical faecal occult blood testing screening at age 50-74 years) and evaluate the incremental effect of improved screening participation under different scenarios. Methods: In this modelling study, a microsimulation model, Policy1-Bowel, which simulates the development of colorectal cancer via both the conventional adenoma-carcinoma and serrated pathways was used to simulate the NBCSP in 2006-40, taking into account the gradual rollout of NBCSP in 2006-20. The base-case scenario assumed 40% screening participation (currently observed behaviour) and two alternative scenarios assuming 50% and 60% participation by 2020 were modelled. Aggregate year-by-year screening, diagnosis, treatment and surveillance-related costs, resource utilisation (number of screening tests and colonoscopies), and health outcomes (incident colorectal cancer cases and colorectal cancer deaths) were estimated, as was the cost-effectiveness of the NBCSP. Findings: With current levels of participation (40%), the NBCSP is expected to prevent 92 200 cancer cases and 59 000 deaths over the period 2015-40; an additional 24 300 and 37 300 cases and 16 800 and 24 800 deaths would be prevented if participation was increased to 50% and 60%, respectively. In 2020, an estimated 101 000 programme-related colonoscopies will be done, associated with about 270 adverse events; an additional 32 500 and 49 800 colonoscopies and 88 and 134 adverse events would occur if participation was increased to 50% and 60%, respectively. The overall number needed to screen (NNS) is 647-788 per death prevented, with 52-59 colonoscopies per death prevented. The programme is cost-effective due to the cancer treatment costs ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| Relation: | https://repub.eur.nl/pub/100707; urn:hdl:1765/100707 |
| DOI: | 10.1016/S2468-2667(17)30105-6 |
| الاتاحة: | https://repub.eur.nl/pub/100707 https://doi.org/10.1016/S2468-2667(17)30105-6 |
| رقم الانضمام: | edsbas.C3402823 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/S2468-2667(17)30105-6 |
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