A comparison of international modeling methods for evaluating health economics of colorectal cancer screening: a systematic review

OBJECTIVES: Cost-effectiveness analysis (CEA) is an accepted approach to evaluate cancer screening programmes. CEA estimates partially depend on modelling methods and assumptions used. Understanding common practice when modelling cancer relies on complete, accessible descriptions of prior work. This review's objective is to comprehensively examine published CEA modelling methods employed to evaluate Colorectal Cancer (CRC) screening from an aspiring modeller's perspective. It compares existing models highlighting the importance of precise modelling method descriptions, and essential factors when modelling CRC progression.

METHODS: MEDLINE, EMBASE, Web of Science and Scopus electronic databases were used. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement and data items from previous systematic reviews formed a template to extract relevant data. Specific focus included model type, natural history, appropriate data sources and survival analysis.

RESULTS: Seventy-eight studies, with 52 unique models found. Twelve previously published models were reported in 39 studies, with 39 newly developed models. CRC progression from the onset was commonly modelled, with only six models not including it as a model component.

CONCLUSIONS: Modelling methods needed to simulate CRC progression depend on the natural history structure and research requirements. For aspiring modellers, accompanying models with clear overviews and extensive modelling assumption descriptions is beneficial. Open-source modelling would also allow model replicability and result in appropriate decisions suggested for CRC screening programmes.