Very-low-dose aspirin and surveillance colonoscopy is cost-effective in secondary prevention of colorectal cancer in individuals with advanced adenomas: network meta-analysis and cost-effectiveness analysis

Table 3 Scenario analyses: Effect of extending colonoscopy surveillance intervals in the combination strategy

Strategies	Total costs (USD)	LYs	QALYs	Incremental costs (USD)	Incremental LYs	Incremental QALYs	ICER (USD/LY gained)	ICER (USD/QALY gained)
Aspirin combined with colonoscopy at up to 5-year intervals
No screening	5757	17.23	10.44	-	-	-	-	-
ASAVLD	5472	17.69	10.60	− 285	0.47	0.17	Dominated^a	Dominated^a
Surveillance colonoscopy (3 years)	4296	18.03	10.81	− 1176	0.34	0.21	Cost-saving	Cost-saving
ASAVLD + surveillance colonoscopy (5 years)	4446	18.34	10.89	150	0.31	0.08	484 (Cost-effective)	1875 (Cost-effective)
Aspirin combined with colonoscopy at up to 10-year intervals
No screening	5757	17.23	10.44	–	–	–	–	–
ASAVLD	5472	17.69	10.60	− 285	0.47	0.17	Dominated^a	Dominated^a
Surveillance colonoscopy (3 years)	4296	18.03	10.81	− 1176	0.34	0.21	Cost-saving	Cost-saving
ASAVLD + surveillance colonoscopy (10 years)	5878	18.11	10.78	1582	0.08	− 0.03	19,775 (Not cost-effective)	Dominated^a
Aspirin combined with colonoscopy every 5-year versus every 3-year
ASAVLD + surveillance colonoscopy (5 years)	4446	18.34	10.89	–	–	–	–	–
ASAVLD + surveillance colonoscopy (3 years)	3679	18.43	10.93	− 767	0.09	0.04	Cost-saving	Cost-saving

The Malaysian ceiling threshold of social willingness to pay (WTP) for interpretation of cost-effectiveness findings considered for the analysis was $7024 /QALY
ASAVLD, very low dose aspirin; ICER, incremental cost-effectiveness ratio; LYs, life-years; QALYs, quality-adjusted life years; USD, US dollar
^aDominated by surveillance colonoscopy (3-year)

ISSN: 1471-230X