Table 1 Cost-effective universal CRC-based LS screening programs
First author, year, country | N | Target population | Age cutoff | Clinical criteria | Tumor testing | Gene sequencing | Relatives cascade testing | Preventive strategy | Tier | ICERs | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Comparisons | LYG | QALY | ||||||||||
Universal CRC-based LS screening programs accepted as cost-effective | ||||||||||||
?Chen 2016, Taiwan | 18.1 | New CRC patients | — | — | IHC+BRAF | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs NS | 6,025 | — |
?Chen 2016, Taiwan | 18.2 | New CRC patients | — | — | IHC | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs NS | 7,088 | — |
?Mvundura 2010, USA | 6.1 | New CRC patients | — | — | IHC+BRAF | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs NS | 22,552 | — |
?Mvundura 2010, USA | 6.2 | New CRC patients | — | — | IHC | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs NS | 23,321 | — |
?Chen 2016, Taiwan | 18.3 | New CRC patients | — | — | MSI | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs NS | 23,872 | — |
?CADTH 2016, Canada | 19.13Ba | New CRC patients (age >50) | — | — | IHC+MLH1 Hyperm. | 4 MMR genes | Y | Colonoscopy every 2 years + TAHBSO at age 45 | — | Vs<70/IHC+MLH1 Hyperm.a | 27,089a | 28,902a |
?Ramsey 2003, USA | 3.6 | New CRC patients | — | — | MSI | MLH1, MSH2 | Y | Subtotal colectomy (only for proband) or colonoscopy every 3 years | 1 | Vs NS | 35,617 | — |
?Ladabaum 2011, USA/Wang G 2012, USA | 9.12b | New CRC patients | — | — | IHC+BRAF | 4 MMR genes | Y | Colonoscopy every year or subtotal colectomy + transvaginal US and endometrial biopsy every year or TAHBSO at age 40 | 1 | Vs NS | 36,200b | 59,719b |
?Mvundura 2010, USA | 6.1 | New CRC patients | — | — | IHC+BRAF | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs <50/IHC+BRAF | 37,010 | — |
?Mvundura 2010, USA | 6.2 | New CRC patients | — | — | IHC | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs <50/IHC | 38,411 | — |
?Mvundura 2010, USA | 6.3 | New CRC patients | — | — | MSI | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs NS | 41,511 | — |
?Barzi 2015, USA | 15.12b | New CRC patients | — | — | IHC+BRAF | 4 MMR genes | Y | Colonoscopy every year + TAHBSO at age 40 | 1 | Vs NS | 46,925b | — |
?Mvundura 2010, USA | 6.3 | New CRC patients | — | — | MSI | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs <50/MSI | 70,792 | — |
Universal CRC-based LS screening programs not accepted as cost-effective | ||||||||||||
?Ladabaum 2011, USA/Wang G 2012, USA | 9.15b | New CRC patients | — | — | MSI+IHC+BRAF | 4 MMR genes | Y | Colonoscopy every year or subtotal colectomy + transvaginal US and endometrial biopsy every year or TAHBSO at age 40 | 1 | Vs IHC+BRAFb | 108,000b | — |
?Ladabaum 2011, USA/Wang G 2012, USA | 9.15 | New CRC patients | — | — | MSI+IHC+BRAF | 4 MMR genes | Y | Colonoscopy every year or subtotal colectomy + transvaginal US and endometrial biopsy every year or TAHBSO at age 40 | 1 | Vs RBG | 117,000 | 193,343 |
?Mvundura 2010, USA | 6.4 | New CRC patients | — | — | — | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs NS | 142,289 | — |
?Barzi 2015, USA | 15.12 | New CRC patients | — | — | IHC+BRAF | 4 MMR genes | Y | Colonoscopy every year + TAHBSO at age 40 | 1 | Vs MMRpro/IHC | 144,117 | — |
?Chen 2016, Taiwan | 18.4 | New CRC patients | — | — | — | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs NS | 145,110 | — |
?Ladabaum 2011, USA/Wang G 2012, USA | 9.14b | New CRC patients | — | — | MSI+IHC | 4 MMR genes | Y | Colonoscopy every year or subtotal colectomy + transvaginal US and endometrial biopsy every year or TAHBSO at age 40 | 1 | Vs IHC+BRAFb | — | 179,576b |
?Ramsey 2003, USA | 3.2 | New CRC patients | — | — | MSI | MLH1, MSH2 | — | Subtotal colectomy (only for proband) or colonoscopy every 3 years | 1 | Vs NS | 213,290 | — |
?Mvundura 2010, USA | 6.4 | New CRC patients | — | — | — | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs <50 | 237,278 | — |
?Severin 2015, Germany | 14.2 | New CRC patients | — | — | IHC+BRAF | 4 MMR genes | Y | Colonoscopy every year + aspirin | 1 | Vs RBG/IHC+BRAF | 258,253 | — |
?Chen 2016, Taiwan | 18.2 | New CRC patients | — | — | IHC | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs IHC+BRAF | 260,824 | — |
?Ramsey 2003, USA | 3.8 | New CRC patients | — | — | — | MLH1, MSH2 | Y | Subtotal colectomy (only for proband) or colonoscopy every 3 years | 1 | Vs NS | 267,548 | — |
?Ladabaum 2011, USA/Wang G 2012, USA | 9.16b | New CRC patients | — | — | — | 4 MMR genes | Y | Colonoscopy every year or subtotal colectomy + transvaginal US and endometrial biopsy every year or TAHBSO at age 40 | 1 | Vs MSI+IHCb | — | 271,219b |
?Mvundura 2010, USA | 6.2 | New CRC patients | — | — | IHC | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs IHC+BRAF | 273,915 | — |
?Ladabaum 2011, USA/Wang G 2012, USA | 9.16 | New CRC patients | — | — | — | 4 MMR genes | Y | Colonoscopy every year or subtotal colectomy + transvaginal US and endometrial biopsy every year or TAHBSO at age 40 | 1 | Vs MSI+IHC+BRAF | 293,000 | 393,303 |
?Chen 2016, Taiwan | 18.3 | New CRC patients | — | — | MSI | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs IHC | 302,129 | — |
?CADTH 2016, Canada | 19.12Ba | New CRC patients (age >50) | — | — | IHC + BRAF | 4 MMR genes | Y | Colonoscopy every 2 years + TAHBSO at age 45 | — | Vs IHC+MLH1 Hyperm.a | 363,043a | 387,330a |
?Ramsey 2003, USA | 3.6 | New CRC patients | — | — | MSI | MLH1, MSH2 | Y | Subtotal colectomy (only for proband) or colonoscopy every 3 years | 1 | Vs Bethesda/MSI | 394,067 | — |
?Barzi 2015, USA | 15.14b | New CRC patients | — | — | MSI+IHC | 4 MMR genes | Y | Colonoscopy every year + TAHBSO at age 40 | 1 | Vs IHC+BRAFb | 400,728b | — |
?Mvundura 2010, USA | 6.2 | New CRC patients | — | — | IHC | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs < 50/IHC+BRAF | 429,973 | — |
?CADTH 2016, Canada | 19.11Ba | New CRC patients (age >50) | — | — | IHC | 4 MMR genes | Y | Colonoscopy every 2 years + TAHBSO at age 45 | — | Vs IHC+BRAFa | 610,447a | 651,283a |
?Mvundura 2010, USA | 6.4 | New CRC patients | — | — | — | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs MSI | 737,025 | — |
?Mvundura 2010, USA | 6.3 | New CRC patients | — | — | MSI | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs IHC | 764,917 | — |
?Barzi 2015, USA | 15.16b | New CRC patients | — | — | — | 4 MMR genes | Y | Colonoscopy every year + TAHBSO at age 40 | 1 | Vs MSI+IHCb | 940,024b | — |
?Chen 2016, Taiwan | 18.4 | New CRC patients | — | — | — | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs MSI | 988,217 | — |
?Barzi 2015, USA | 15.16 | New CRC patients | — | — | — | 4 MMR genes | Y | Colonoscopy every year + TAHBSO at age 40 | 1 | Vs MMRpro | 996,878 | — |
?Mvundura 2010, USA | 6.4 | New CRC patients | — | — | — | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs < 50/MSI | 1,192,575 | — |
?Mvundura 2010, USA | 6.3 | New CRC patients | — | — | MSI | 4 MMR genes | Y | Colonoscopy every 2 years | 1 | Vs <50/IHC | 1,355,910 | — |
?Ramsey 2003, USA | 3.8 | New CRC patients | — | — | — | MLH1, MSH2 | Y | Subtotal colectomy (only for proband) or colonoscopy every 3 years | 1 | Vs Bethesda/MSI | 1,485,640 | — |
?Ramsey 2003, USA | 3.4 | New CRC patients | — | — | — | MLH1, MSH2 | — | Subtotal colectomy (only for proband) or colonoscopy every 3 years | 1 | Vs NS | 1,625,687 | — |
?Ramsey 2003, USA | 3.8 | New CRC patients | — | — | — | MLH1, MSH2 | Y | Subtotal colectomy (only for proband) or colonoscopy every 3 years | 1 | Vs MSI | 1,989,197 | — |
?Ramsey 2003, USA | 3.8 | New CRC patients | — | — | — | MLH1, MSH2 | Y | Subtotal colectomy (only for proband) or colonoscopy every 3 years | 1 | Vs Bethesda | 2,553,345 | — |
?Severin 2015, Germany | 14.7 | New CRC patients | — | — | — | 4 MMR genes | Y | Colonoscopy every year + aspirin | 1 | Vs IHC+BRAF | 4,188,036 | — |
