Quality of Life of Patients With Colorectal Neoplasm and Cost-Effectiveness Analysis of Colorectal Cancer Screening

The aims are to determine the HRQOL and health preference (utility) of different stages of colorectal neoplasm in order to evaluate the cost-effectiveness of different CRC screening strategies for the Chinese population in Hong Kong. The specific objectives are: 1. To determine the HRQOL preference values of patients in different stage of colorectal neoplasm in order to estimate the quality of life adjustment applicable to each stage of colorectal neoplasm. 2. To evaluate the HRQOL of patients with colorectal neoplasm in order to find out their concerns and needs. 3. To find out whether HRQOL preference of people with colorectal neoplasm changes with time. 4. To determine the expected life years gained from the reduction in the incidence and mortality rates of CRC for each CRC screening strategy base on literature review. 5. To determine the QALY gained from each CRC strategy by combining the preference value with life years gained. 6. To identify the most cost-effective CRC screening strategy and to determine the incremental cost per additional QALY gained compared to no screening, by Markov modelling. The study hypotheses are: 1. Patients with colorectal neoplasm including those with polyps have lower HRQOL than the general population. 2. There is a gradient reduction in HRQOL preference among patients with different stages colorectal neoplasm from polyp to metastatic cancer. 3. HRQOL preference of patients with colorectal neoplasm is stable if there is no change in the disease stage. 4. Annual I-FOBT is the most cost-effective CRC screening strategy for the Chinese population in Hong Kong.