Adoption of colonoscopy surveillance intervals in subjects who received polypectomy in southern China: A cost‐effectiveness analysis
Background and Aim We 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. Methods We constructed a Markov model with a hypothetical population of 100 000 individuals aged 50–85 years...
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| Veröffentlicht in: | Journal of gastroenterology and hepatology Jg. 38; H. 11; S. 1963 - 1970 |
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| Hauptverfasser: | , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
Australia
Wiley Subscription Services, Inc
01.11.2023
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| Schlagworte: | |
| ISSN: | 0815-9319, 1440-1746, 1440-1746 |
| Online-Zugang: | Volltext |
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| Zusammenfassung: | Background and Aim
We 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.
Methods
We 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.
Results
Compared 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.
Conclusions
A 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.
A 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. |
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| Bibliographie: | Declaration of conflict of interest Authors contributions Yunyang Deng and Martin Chi Sang Wong conceived and designed this study. Yunyang Deng and Hanyue Ding conducted the data collection, analyzed the data, and drafted the manuscript. Hanyue Ding and Junjie Huang proofread the data and manuscript. Martin Chi Sang Wong critically revised the manuscript. All authors approved the submitted version. Yunyang Deng and Hanyue Ding contribute equally. Financial support Because this is a cost‐effective analysis with a simulation model that did not involve humans or animals and all used data are publicly available, ethics approvals and written informed consents were not required. Ethical approval Authors declare no conflict of interests for this article. This study was funded by the Health and Medical Research Fund (No. 07180596), Food and Health Bureau, Hong Kong. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 |
| ISSN: | 0815-9319 1440-1746 1440-1746 |
| DOI: | 10.1111/jgh.16316 |