Cost-Effectiveness Analysis of CT Colonography for Colorectal Cancer Screening Program to Working Age in Japan

Objectives: To assess the cost-effectiveness of computed tomography colonography (CTC) for a colorectal cancer screening program in a working population (aged 40–60 years) from a health care payer’s perspective in Japan. Methods: A Markov model for colorectal cancer was constructed to estimate the long-term (10-year, 20-year, and 30year) effect of introducing CTC for three different strategies in the cohort aged 40 years on April 1, 2011. Strategy 1 (the current strategy in Japan): fecal occult blood test (FOBT) followed by optical colonoscopy (OC). In this case, 41.8% of those who were FOBT-positive did not undergo OC (uptake 58.2%). Strategy 2: All FOBT-positive cases would be offered CTC (uptake 79.1%) followed by OC. Strategy 3: Only those FOBT-positive cases who were reluctant to undergo OC (41.8%) would be offered CTC (assumed uptake 50.0%) followed by OC. Epidemiological data were obtained mainly from statistics published by the Japanese National Cancer Center. We set quality-adjusted lifeyear (QALY) as the primary outcome and colorectal cancer death and expected life-years as secondary ones. The discount rate for both costs ee front matter Copyright & 2014, International S