Benefit-Harm Analysis for Informed Decision Making on Participating in Colorectal Cancer Screening: A Modeling Study

Apr 1, 2024, 00:00
10.1016/j.jval.2023.12.006
https://www.valueinhealthjournal.com/article/S1098-3015(23)06238-1/fulltext
Title : Benefit-Harm Analysis for Informed Decision Making on Participating in Colorectal Cancer Screening: A Modeling Study
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(23)06238-1&doi=10.1016/j.jval.2023.12.006
First page : 397
Section Title : COMPARATIVE-EFFECTIVENESS RESEARCH/HTA
Open access? : Yes
Section Order : 397

Objectives

To facilitate informed decision making on participating in colorectal cancer (CRC) screening, we assessed the benefit-harm balance of CRC screening for a wide range of subgroups over different time horizons.

Methods

The study combined incidence proportions of benefits and harms of (not) participating in CRC screening estimated by the Adenoma and Serrated pathway to CAncer microsimulation model, a preference eliciting survey, and benefit-harm balance modeling combining all outcomes to determine the net health benefit of CRC screening over 10, 20, and 30 years. Probability of net health benefit was estimated for 210 different subgroups based on age, sex, previous participation in CRC screening, and lifestyle.

Results

CRC screening was net beneficial in 183 of 210 subgroups over 30 years (median probability [MP] of 0.79, interquartile range [IQR] of 0.69-0.85) across subgroups. Net health benefit was greater for men (MP 0.82; IQR 0.69-0.89) than women (MP 0.76; IQR 0.67-0.83) and for those without history of participation in previous screenings (MP 0.84; IQR 0.80-0.89) compared with those with (MP 0.69; IQR 0.59-0.75). Net health benefit decreased with increasing age, from MP of 0.84 (IQR 0.80-0.86) at age 55 to 0.61 (IQR 0.56-0.71) at age 75. Shorter time horizons led to lower benefit, with MP of 0.70 (IQR 0.62-0.80) over 20 years and 0.54 (IQR 0.48-0.67) over 10 years.

Conclusions

Our benefit-harm analysis provides information about net health benefit of screening participation, based on important characteristics and preferences of individuals, which could assist screening invitees in making informed decisions on screening participation.

Categories :
  • Decision & Deliberative Processes
  • Decision Modeling & Simulation
  • Epidemiology & Public Health
  • Health Technology Assessment
  • Oncology
  • Prevalence, Incidence & Disease Risk Factors
  • Specific Diseases & Conditions
  • Study Approaches
Tags :
  • benefit-harm balance
  • colorectal cancer
  • informed decision making
  • microsimulation modeling
Regions :
  • Western Europe
ViH Article Tags :