Colorectal neoplasia screening with virtual colonoscopy: when, at what cost, and with what national impact?  Uri Ladabaum, Kenneth Song, A.Mark Fendrick  Clinical Gastroenterology and Hepatology  Volume 2, Issue 7, Pages 554-563 (July 2004) DOI: 10.1016/S1542-3565(04)00247-2

Figure 1 Impact of test cost on the incremental cost-effectiveness of a screening colonoscopy strategy compared with a virtual colonoscopy screening strategy (test performance as reported by Pickhardt et al.12). The incremental cost-effectiveness was highly dependent on the cost ratio of virtual colonoscopy to diagnostic colonoscopy. When this ratio was ≥0.73, screening colonoscopy was more effective and less costly (dominant). When this ratio was ≤0.60, the screening colonoscopy strategy became quite costly in comparison to the virtual colonoscopy strategy. Clinical Gastroenterology and Hepatology 2004 2, 554-563DOI: (10.1016/S1542-3565(04)00247-2)

Figure 2 Impact of colorectal cancer risk on the relative effectiveness of the strategies. At average risk (relative risk = 1), screening colonoscopy gained more life-years than virtual colonoscopy. This advantage became more pronounced as the relative risk for colorectal neoplasia increased. For low-risk persons, the noninvasive radiologic strategies could be superior. VC-base, virtual colonoscopy every 10 years with base-case test performance characteristics (Table 1); VC-Pickhardt, virtual colonoscopy every 10 years with test performance as reported by Pickhardt et al.12 Clinical Gastroenterology and Hepatology 2004 2, 554-563DOI: (10.1016/S1542-3565(04)00247-2)