Comparative Effectiveness and Cost Effectiveness of a Multitarget Stool DNA Test to Screen for Colorectal Neoplasia  Uri Ladabaum, Ajitha Mannalithara  Gastroenterology  Volume 151, Issue 3, Pages 427-439.e6 (September 2016) DOI: 10.1053/j.gastro.2016.06.003 Copyright © 2016 AGA Institute Terms and Conditions

Figure 1 Effectiveness (discounted quality-adjusted life years per person) and cost (discounted dollars per person) for screening strategies. FIT with 100% consistent screening participation and without additional patient support costs was cost-saving compared with no screening. MT-sDNA achieved effectiveness similar to the other strategies given the same levels of patient participation, but it was more costly. Participation rates of 50% consistent screening and 27% intermittent screening are representative of successful organized screening programs, and the results for FIT with these participation rates include patient support costs of $153 per testing cycle. Gastroenterology 2016 151, 427-439.e6DOI: (10.1053/j.gastro.2016.06.003) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 1 Schematic of the natural history module in the decision analytic model. The principal health states in the model are normal, small adenomatous polyp, large adenomatous polyp, localized colorectal cancer (CRC-L), regional colorectal cancer (CRC-R), disseminated colorectal cancer (CRC-D), alive after treatment for localized colorectal cancer (s/p CRC-L), alive after treatment for regional colorectal cancer (s/p CRC-R), and dead. Without screening, colorectal cancer is diagnosed and treated (Rx) only after symptoms (Sx) develop. Gastroenterology 2016 151, 427-439.e6DOI: (10.1053/j.gastro.2016.06.003) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 2 Effectiveness (discounted QALYs/person) and cost (discounted dollars/person) for screening with MT-sDNA at progressively higher frequencies. Each arrow points to a line segment whose slope is the incremental cost per QALY gained of the shorter vs the longer screening interval that are represented by the 2 points joined by the line segment. Gastroenterology 2016 151, 427-439.e6DOI: (10.1053/j.gastro.2016.06.003) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 3 Effectiveness (discounted QALYs/person) and cost (discounted dollars/person) for screening with MT-sDNA at progressively higher frequencies (sensitivity analysis with Medicare costs assumed for all ages). Each arrow points to a line segment whose slope is the incremental cost per QALY gained of the shorter vs the longer screening interval that are represented by the 2 points joined by the line segment. Gastroenterology 2016 151, 427-439.e6DOI: (10.1053/j.gastro.2016.06.003) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 4 Effectiveness (discounted QALYs/person) and cost (discounted dollars/person) for screening strategies. Gastroenterology 2016 151, 427-439.e6DOI: (10.1053/j.gastro.2016.06.003) Copyright © 2016 AGA Institute Terms and Conditions