Updates on age to start and stop colorectal cancer screening: recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer

Patel, Swati; May, Folasade P.; Anderson, Joseph C.; Burke, Carol A.; Dominitz, Jason A.; Gross, Seth A.; Jacobson, Brian C.; Shaukat, Aasma; Robertson, Douglas J.

doi:10.1016/j.gie.2021.06.012

Cited by 14 publications

(8 citation statements)

References 94 publications

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“…Seventh, the cost and utility were not considered in the present analysis, because our model temporarily aimed to elucidate the efficacy of CRC screening strategies, which fully disclose the effect of CRC screening regardless of costs and medical resources. With the constant improvement of MIMIC-CRC, the model could be used to evaluate the cost-effectiveness of existing screening strategies (38), optimize the details of existing screening and surveillance modalities (39,40), and explore the impact of social (41), economic (42), and disease intervention (43,44) in CRC screening. While the model is not perfect currently, it can be extended in a variety of ways when data are supportive.…”

Section: Discussionmentioning

confidence: 99%

Microsimulation Model for Prevention and Intervention of Coloretal Cancer in China (MIMIC-CRC): Development, Calibration, Validation, and Application

Lü

Wang

et al. 2022

Front. Oncol.

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IntroductionA microsimulation model provides important references for decision-making regarding colorectal cancer (CRC) prevention strategies, yet such a well-validated model is scarce in China.MethodsWe comprehensively introduce the development of MIcrosimulation Model for the prevention and Intervention of Colorectal Cancer in China (MIMIC-CRC). The MIMIC-CRC was first constructed to simulate the natural history of CRC based on the adenoma-carcinoma pathway. The parameters were calibrated and validated using data from population-based cancer registry data and CRC screening programs. Furthermore, to assess the model’s external validity, we compared the model-derived results to outcome patterns of a sigmoidoscopy screening trial in the UK [UK Flexible Sigmoidoscopy Screening (UKFSS) trial]. Finally, we evaluated the application potential of the MIMIC-CRC model in CRC screening by comparing the 8 different strategies.ResultsWe found that most of the model-predicted colorectal lesion prevalence was within the 95% CIs of observed prevalence in a large population-based CRC screening program in China. In addition, model-predicted sex- and age-specific CRC incidence and mortality were equivalent to the registry-based data. The hazard ratios of model-estimated CRC-related incidence and mortality for sigmoidoscopy screening compared to no screening were 0.60 and 0.51, respectively, which were comparable to the reported results of the UKFSS trial. Moreover, we found that all 8 strategies could reduce CRC incidence and mortality compared to no screening.ConclusionsThe well-calibrated and validated MIMIC-CRC model may represent a valid tool to assess the comparative effectiveness of CRC screening strategies and will be useful for further decision-making to CRC prevention.

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Section: Discussionmentioning

confidence: 99%

Microsimulation Model for Prevention and Intervention of Coloretal Cancer in China (MIMIC-CRC): Development, Calibration, Validation, and Application

Lü

Wang

et al. 2022

Front. Oncol.

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“…After this merge, patients with no complete exam with adequate bowel preparation were excluded. Although the current recommendation is to start colorectal cancer screening at age 45 ( 10 ), we used 50 years as the age to begin colorectal cancer screening in order to reflect the recommendation that was in place during the time period of our analysis.…”

Section: Methodsmentioning

confidence: 99%

Colonoscopy Findings in FIT+ and mt-sDNA+ Patients versus in Colonoscopy-only Patients: New Hampshire Colonoscopy Registry Data

Anderson

Robinson

Hisey

et al. 2022

Cancer Prevention Research

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Few studies compare fecal immunochemical test (FIT) and multi-target stool DNA (mt-sDNA) outcomes in practice. We compared colonoscopy yield following FIT+ or mt-sDNA+ tests to colonoscopies without preceding stool tests in the comprehensive population-based New Hampshire Colonoscopy Registry (NHCR). Outcomes were any neoplasia and an ordered outcome: adenocarcinoma, advanced neoplasia (adenoma/serrated polyp {greater than or equal to} 1 cm/villous/high-grade dysplasia), non-advanced neoplasia or normal. Our total sample included 306 mt-sDNA+ (average age +/- SD 67.0 +/- 7.9), 276 FIT+ (66.6 +/- 8.7) and 50,990 colonoscopy-only patients (61.8 +/- 8.1). Among average risk patients (N=240 mt-sDNA+, N=194 FIT+ , N=26,221 colonoscopy only), mt-sDNA+ patients had a higher risk for any neoplasia (67.1%) compared to FIT+ (54.6%, p=0.00098) or colonoscopy (40.8%, p < 0.0001). Severity of findings and histology subtypes differed across the three groups (p<0.0001 for both), with a higher yield of advanced findings in mt-sDNA+ patients. In particular, clinically relevant serrated polyps (hyperplastic polyps {greater than or equal to} 10 mm/traditional serrated adenomas/sessile serrated polyps) were detected at a higher frequency in mt-sDNA+ patients as compared to FIT+ or colonoscopy only patients. Even after adjustment, patients with positive mt-sDNA+ (OR=2.82; 95%CI: 2.00-4.02) or FIT+ tests (OR=1.67; 95% CI: 1.19-2.36) were more likely to have histologically more advanced findings than colonoscopy alone. At follow-up colonoscopy, mt-sDNA+ tests were more likely to predict neoplasia than FIT+, largely due to increased detection of serrated polyps.

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“…Con una recomendación A en el grupo de edad de 50 a 75 años, con recomendación recomendación B en el de 45 a 49 años y recomendación C de forma selectiva en adultos de 76 a 85 años, teniendo en cuenta la salud general del paciente, los resultados de los cribados previos y las preferencias 72 . La U.S. Multi-Society Task Force on Colorectal Cancer, que representa al American College of Gastroenterology, la American Gastroenterological Association y la American Society for Gastrointestinal Endoscopy, aunque no hay datos clínicos sobre el impacto del cribado del CCR en individuos menores de 50 años sobre la incidencia del CCR o la mortalidad relacionada con el mismo, afirman que hay suficientes datos de apoyo para recomendar que el cribado del CCR de riesgo medio comience a los 45 años 73 .…”

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Recomendaciones de Prevención del Cáncer. Actualización PAPPS 2022

et al. 2022

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Updates on age to start and stop colorectal cancer screening: recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer

Cited by 14 publications

References 94 publications

Microsimulation Model for Prevention and Intervention of Coloretal Cancer in China (MIMIC-CRC): Development, Calibration, Validation, and Application

Microsimulation Model for Prevention and Intervention of Coloretal Cancer in China (MIMIC-CRC): Development, Calibration, Validation, and Application

Colonoscopy Findings in FIT+ and mt-sDNA+ Patients versus in Colonoscopy-only Patients: New Hampshire Colonoscopy Registry Data

Recomendaciones de Prevención del Cáncer. Actualización PAPPS 2022

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