High-resolution microendoscopy for esophageal cancer screening in China: A cost-effectiveness analysis

Table 1 Model inputs

Parameters	Base	Range	Ref.
Costs (I$: equivalent to 2012 USD)
Cost of cancer (annual)	I$3376		[26-29] (conversion-ratio)
Cost of screening (endoscopy + mucosal iodine staining + biopsy)	I$64	I$58.5-63.6	[13]
Cost of EGD	I$35.8		[30]
Cost of biopsy	I$28.2		[30]
Cost of HRME	I$35.8
Cost of EMR	I$1292	I$1292-1620	[13]
Cost of EMR-related stricture	I$1111		[31] (conversion-ratio)
Cost of EMR-related perforation	I$1786		[31] (conversion-ratio)
Cost of esophagectomy	I$1768	I$1485-2171	[13]
Cost of post surgery state (annual)	I$136		[19,27,28] (conversion-ratio)
Discount rate, %	0.03
Transition probabilities
Non-neoplasia to mild dysplasia			Calibrated to overall annual ESCC incidence rate by age group-CI5[10]Overall cumulative incidence in follow-up study[11]
Mild to moderate dysplasia
Moderate to severe dysplasia
Severe dysplasia to IMC
IMC to operable cancer
Screening test characteristics (per patient)
Lugol’s iodine testing
Sensitivity	0.99		[8]
Specificity	0.15		[8]
HRME testing
Sensitivity	0.99		[8]
Specificity	0.82		[8]
Efficacy of EMR
Complete long-term remission	0.62		[32]
Adherence rate (compliance of screening)
After positive biopsy	0.70		[13]
Procedure characteristics
Operative candidate, cancer	0.86		[33]
Surgical resectability rate
Surveillance	0.76		[33]
No surveillance	0.33		[14,15]
Complications of therapy
Post-EMR stricture rate	0.05		[34]
Post-EMR perforation rate	0.02		[34]
Post-RFA structure rate	0.14		[25]
Complication rate from EGD	< 0.01		[14,35,36]
Mortality from EGD complication	< 0.01		[14,35,36]

C15: Cancer Incidence in Five Continents; EGD: Esophagogastroduodenoscopy; EMR: Endoscopic mucosal resection; HRME: High-resolution microendoscopy; IMC: Intramucosal carcinoma; RFA: Radiofrequency ablation.