Evaluating Test Strategies for Colorectal Cancer Screening: A Decision Analysis for the U.S. Preventive Services Task Force

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Appendix Table. Efficient and Near-Efficient Strategies^a

Test, Age Begin-Age Stop, Interval^b	Outcomes per 1000 Persons
Test, Age Begin-Age Stop, Interval^b	COL	Non-COL Tests	LYG	ΔCOL	ΔLYG	ΔCOL/ΔLYG^c
Colonoscopy screening
MISCAN
COL, 60-75, 20	2175	0	156	-	-	-
COL, 50-75, 20	3325	0	203	1150	47	24.7
COL, 50-75, 10	4136	0	230	811	27	29.6
COL, 50-85, 10	4534	0	236	398	5	72.9
COL, 50-75, 5	5895	0	254	1362	18	74.8
COL, 50-85, 5	6560	0	257	565	4	156.1
SimCRC
COL, 60-75, 20	1780	0	165	-	-	-
COL, 50-75, 20	2885	0	246	1106	82	13.5
COL, 50-75, 10	3756	0	271	871	25	34.7
COL, 50-85, 10	4114	0	273	-	-	Near-efficient
COL, 50-75, 5	5572	0	281.6	1816	10	178.8
COL, 50-85, 5	6031	0	282.1	459	0.5	975.7
Hemoccult II
MISCAN
Hemoccult II, 60-75, 3	681	4435	89	-	-	-
Hemoccult II, 60-75, 2	854	5784	105	172	16	10.6
Hemoccult II, 50-75, 3	1033	6834	121	-	-	Near-efficient
Hemoccult II, 50-75, 2	1335	9510	149	482	44	11.0
Hemoccult II, 50-85, 2	1513	11,162	158	-	-	Near-efficient
Hemoccult II, 50-75, 1	1982	16,232	194	647	45	14.3
Hemoccult II, 50-85, 1	2186	18,262	202	203	8	25.5
SimCRC
Hemoccult II, 60-75, 3	425	4291	75	-	-	-
Hemoccult II, 50-75, 3	699	6941	129	275	54	5.1
Hemoccult II, 50-75, 2	921	9422	162	221	33	6.7
Hemoccult II, 50-75, 1	1456	16,239	218	536	55	9.6
Hemoccult II, 50-85, 1	1712	18,409	223	256	5	47.9
Hemoccult SENSA
MISCAN
Hemoccult SENSA, 60-75, 3	1363	3824	134	-	-	-
Hemoccult SENSA, 60-75, 2	1647	4732	149	-	-	Near-efficient
Hemoccult SENSA, 50-75, 3	2121	5596	181	758	47	16.0
Hemoccult SENSA, 50-75, 2	2584	7014	205	463	24	19.5
Hemoccult SENSA, 50-85, 2	2801	7679	211	-	-	Near-efficient
Hemoccult SENSA, 50-75, 1	3350	9541	230	766	25	30.9
Hemoccult SENSA, 50-85, 1	3538	9904	232	188	2	80.6
SimCRC
Hemoccult SENSA, 60-75, 3	934	3735	123	-	-	-
Hemoccult SENSA, 50-75, 3	1587	5554	201	663	78	8.4
Hemoccult SENSA, 50-75, 2	1957	7006	228	370	28	13.3
Hemoccult SENSA, 50-75, 1	2654	9573	259	698	31	22.9
Hemoccult SENSA, 50-85, 1	2996	9918	262	341	3	128.2
Fecal immunochemical test
MISCAN
FIT, 60-75, 3	1158	4037	129	-	-	-
FIT, 60-75, 2	1403	5098	144	-	-	Near-efficient
FIT, 50-75, 3	1769	6089	173	611	44	14.0
FIT, 50-75, 2	2184	7916	198	415	25	16.5
FIT, 50-85, 2	2396	8895	206	-	-	Near-efficient
FIT, 50-75, 1	2949	11,773	227	765	30	25.9
FIT, 50-85, 1	3155	12,582	231	206	4	49.1
SimCRC
FIT, 60-75, 3	772	3943	118	-	-	-
FIT, 50-75, 3	1286	6047	193	514	75	6.9
FIT, 50-75, 2	1614	7908	222	327	29	11.3
FIT, 50-75, 1	2295	11,830	256	681	35	19.7
FIT, 50-85, 1	2623	12,587	260	328	3	95.7
Flexible sigmoidoscopy
MISCAN
FSIG, 60-75, 20	1047	917	114	-	-	-
FSIG, 60-75, 10	1311	1531	140	-	-	Near-efficient
FSIG, 60-75, 5	1491	2617	159	-	-	Near-efficient
FSIG, 50-75, 10	1685	2339	177	-	-	Near-efficient
FSIG, 50-75, 5	1911	4139	203	864	889	9.7
FSIG, 50-85, 5	1996	4745	207	85	4	22.3
SimCRC
FSIG, 60-75, 20	438	889	94	-	-	-
FSIG, 50-75, 20	662	1662	147	224	53	4.2
FSIG, 50-85, 20	674	1661	147	-	-	Near-efficient
FSIG, 50-85, 10	808	2455	176	146	29	5.0
FSIG, 50-75, 5	995	4483	199	187	22	8.4
FSIG, 50-85, 5	1064	5088	201	68	2	38.5
Flexible sigmoidoscopy plus Hemoccult SENSA
MISCAN
FSIG + SENSA, 60-75, 20, 3	1817	3211	163	-	-	-
FSIG + SENSA, 60-75, 10, 3	1933	3584	171	-	-	Near-efficient
FSIG + SENSA, 60-75, 5, 3	2031	3338	179	213	15	14.0
FSIG + SENSA, 50-75, 20, 3	2658	5210	213	-	-	Near-efficient
FSIG + SENSA, 50-75, 10, 3	2756	5575	221	-	-	Near-efficient
FSIG + SENSA, 50-75, 5, 3	2870	5822	230	839	52	16.3
FSIG + SENSA, 50-85, 5, 3	3042	7348	233	172	3	60.7
FSIG + SENSA, 50-75, 5, 2	3142	6263	235	100	2	62.3
FSIG + SENSA, 50-85, 10, 2	3245	6594	232	-	-	Near-efficient
FSIG + SENSA, 50-85, 5, 2	3321	7969	237	179	2	74.3
FSIG + SENSA, 50-75, 20, 1	3558	8563	236	-	-	Near-efficient
FSIG + SENSA, 50-75, 10, 1	3591	8399	237	-	-	Near-efficient
FSIG + SENSA, 50-75, 5, 1	3635	7224	239	314	2	139.8
FSIG + SENSA, 50-85, 20, 1	3734	8884	238	-	-	Near-efficient
FSIG + SENSA, 50-85, 10, 1	3768	8716	239	-	-	Near-efficient
FSIG + SENSA, 50-85, 5, 1	3808	8816	240	172	1	154.5
SimCRC
FSIG + SENSA, 60-75, 20, 3	956	7763	152	-	-	-
FSIG + SENSA, 60-75, 10, 3	999	11,104	161	44	9	4.7
FSIG + SENSA, 60-75, 5, 3	1045	10,064	169	45	8	5.5
FSIG + SENSA, 50-75, 10, 3	1621	12,485	246	-	-	Near-efficient
FSIG + SENSA, 50-75, 5, 3	1655	11,623	257	611	88	7.0
FSIG + SENSA, 50-85, 5, 3	1908	9484	260	-	-	Near-efficient
FSIG + SENSA, 50-75, 5, 2	1994	12,265	265	338	8	41.7
FSIG + SENSA, 50-85, 5, 2	2298	9895	268	-	-	Near-efficient
FSIG + SENSA, 50-75, 20, 1	2647	10,214	270	-	-	Near-efficient
FSIG + SENSA, 50-75, 10, 1	2653	14,403	271	-	-	Near-efficient
FSIG + SENSA, 50-75, 5, 1	2666	13,593	274	673	9	75.7
FSIG + SENSA, 50-85, 20, 1	2981	7133	272	-	-	Near-efficient
FSIG + SENSA, 50-85, 10, 1	2987	5794	274	-	-	Near-efficient
FSIG + SENSA, 50-85, 5, 1	2996	10,875	276	330	2	154.4

COL = colonoscopy; FIT = fecal immunochemical test; FSIG = flexible sigmoidoscopy; LYG = life-years gained compared with no screening; SENSA = Hemoccult SENSA; ΔCOL = incremental number of colonoscopies compared with the next-best nondominated strategy; ΔLYG = incremental number of life-years gained compared with the next-best nondominated strategy; MISCAN = Microsimulation Screening Analysis; SimCRC = Simulation Model of Colorectal Cancer.

a. Bold indicates recommendable strategy.
b. Age and intervals expressed as years.
c. Near-efficient strategies yield life-years gained within 98% of the efficient frontier.

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Appendix Table. Efficient and Near-Efficient Strategiesa

Appendix Table. Efficient and Near-Efficient Strategies^a