Table 3. Preferred Strategy at Different Levels of "Acceptable" Costs per Life-year Saved

Studies Most Effective Strategy 1 Preferred Strategy if Willing to Pay:2
Less than $20,000 per life-year saved $20-30,000 per life-year saved $30-50,000 per life-year saved $50-100,000 per life-year saved
Wagner et al. 1996 (6) (alternative)3 FOBT + FS5 COL q106 COL q10 FOBT + FS FOBT + FS
Frazier et al. 2000 (8) FOBT + FS FOBT q17 FOBT q1 FOBT + FS FOBT + FS
Khandker et al. 2000 (9) COL q10 FS q58 FS q5 FOBT q1 COL q10
Sonnenberg et al. 2000 (10) COL q10 COL q10 COL q10 COL q10 COL q10
Vijan et al. 2001 (11) FOBT + FS FOBT q1 FOBT q1 COL 55/654 COL 55/65

1Most effective strategy=largest number of life-years saved among five main strategies.
2All costs in year 2000 dollars.
3Using sensitivity of DCBE=50 percent rather than 70 percent used in base-case.
4Colonoscopy at ages 55 and 65 only. All costs in year 2000 U.S. dollars.

Abbreviations
5FOBT + FS: Annual FOBT and FS every 5 years.
6COL q10: Colonoscopy every 10 years.
7FOBT q1: Annual fecal occult blood test.
8FS q5: Flexible sigmoidoscopy every 5 years.
DCBE q5: Double contrast barium enema every 5 years.


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