Using resource modelling to inform decision making and service planning: the case of colorectal cancer screening in Ireland

Table 2 Estimated screening-related resource use and health outcomes by year and screening scenario: biennial gFOBT at 55–74 years, biennial FIT at 55–74 years, and FSIG once at 60 years

*Year of programme*			*Year 1*			*Year 10*
*Screening scenario*			*gFOBT*	*FIT*	*FSIG*	*gFOBT*	*FIT*	*FSIG*
Screening-related resource use
*Screening tests*	No. of kits sent out		357,812	357,812		420,151	417,464
	No. of kits processed		189,640	189,640		222,637	220,999
	No. of FSIG done¹				18,617			20,625
*COL/CTC*	No. of diagnostic COL		967	11,095	381	1,103	12,414	423
	No. of diagnostic CTC		126	1,442	50	143	1,614	55
	No. of surveillance COL		0	0	0	297	2,406	620
	No. of surveillance CTC		0	0	0	39	313	81
*Pathology*	No. of adenomas and CRCs requiring pathology²		1,004	7,161	1,599	1,356	8,909	2,222
*CRC work-up and treatment*	No. receiving PET scan		31	85	6	34	69	8
	No. receiving MRI scan		111	307	23	121	247	28
	No. receiving CT scan(s)		309	853	64	336	687	78
	No. receiving TUS		16	43	3	17	35	4
	No. receiving pre-operative radiotherapy³		71	196	15	75	146	17
	No. undergoing colorectal resection⁴		281	779	59	307	635	71
Screening-related health outcomes
*Harms* ⁵	No. with major bleeding following endoscopy		4	48	7	6	62	10
	No. with perforation following endoscopy		2	21	1	2	27	2
	No. of deaths from perforation following endoscopy		0	1	0	0	1	0
*Screen-detected lesions*	No. with adenoma(s)⁶	Total	366	3,320	808	537	4,327	1,128
	low-risk		229	2,081	544	333	2,770	740
	intermediate/high-risk		137	1,239	264	204	1,558	388
	No. with CRC⁷	Total	309	853	64	336	687	78
	stage I		111	308	23	130	303	31
	stage II		105	293	22	115	237	26
	stage III		69	192	14	68	115	16
	stage IV		24	60	4	23	31	5

COL colonoscopy, CRC colorectal cancer, CTC CT colonography, gFOBT guaiac-based faecal occult blood test, FIT faecal immunochemical test, FSIG flexible sigmoidoscopy, TUS ultrasound; intermediate/high-risk = adenoma(s) ≥10 mm; low-risk = adenoma(s) <10 mm;
¹ includes FSIG with and without polypectomy.
² sum of number of adenomas and colorectal cancers requiring pathology, assuming average of 1.9 adenomas per person; includes screen-detected and surveillance-detected adenomas.
³ applies to rectal cancer only; includes radiotherapy given with or without chemotherapy.
⁴ sum of estimates of colon and rectal resections required.
⁵ includes complications from diagnostic and surveillance endoscopy, including FSIG where relevant.
⁶ includes individuals with screen-detected and surveillance-detected adenomas.
⁷ includes individuals with CRC detected at screening and at surveillance.

ISSN: 1472-6963