Download or read book Evaluating Test Strategies for Colorectal Cancer Screening Age to Begin Age to Stop and Timing of Screening Intervals A Decision Analysis of Colorectal Cancer Screening for the U S Preventive Se written by and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Evaluating Test Strategies for Colorectal Cancer Screening written by Ann G. Zauber and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: The U.S. Preventive Services Task Force requested a decision analysis to inform their update of the recommendations for colorectal cancer (CRC) screening. OBJECTIVE: To assess life-years gained and colonoscopy requirements for CRC screening strategies and identify a set of recommendable screening strategies. DESIGN: Decision analysis using two CRC microsimulation models from the Cancer Intervention and Surveillance Modeling Network. DATA SOURCES: Derived from recent published literature on test characteristics of single use applications of various screening strategies. TARGET POPULATION: U.S. average-risk 40-year-old population. PERSPECTIVE: Societal. TIME HORIZON: Lifetime. INTERVENTIONS: Fecal occult blood tests (FOBTs), flexible sigmoidoscopy, or colonoscopy screening beginning at age 40, 50, or 60 and stopping at age 75 or 85 with screening intervals of 1, 2, or 3 years for FOBT and 5, 10, or 20 years for sigmoidoscopy and colonoscopy. OUTCOME MEASURES: Number of life-years gained compared with no screening and number of colonoscopies and non-colonoscopy tests required. RESULTS OF BASE-CASE ANALYSIS: Beginning screening at age 50 was consistently better than age 60. Lowering the stop age from 85 to 75 decreased life-years gained by 1% to 4%, while colonoscopy use fell by 4% to 15%. Assuming equally high adherence, four strategies provided comparable life-years gained, namely 10-yearly colonoscopy, annual Hemoccult SENSA or fecal immunochemical test, and 5-yearly flexible sigmoidoscopy in conjunction with Hemoccult SENSA every 2 to 3 years. Annual Hemoccult II alone and 5-yearly flexible sigmoidoscopy alone were less effective. RESULTS OF SENSITIVITY ANALYSIS: The results were most sensitive to beginning screening at age 40. LIMITATIONS: Stopping age for screening was based only on chronological age. CONCLUSIONS: Our findings support CRC screening from ages 50 to 75 with annual screening with a high sensitivity FOBT, 10-yearly colonoscopy, or high sensitivity FOBT every 2 to 3 years with a 5-yearly flexible sigmoidoscopy.
Download or read book Evaluating Test Strategies for Colorectal Cancer Screening Age to Begin Age to Stop and Timing of Screening Intervals written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-06-26 with total page 66 pages. Available in PDF, EPUB and Kindle. Book excerpt: Despite recent declines in both incidence and mortality, colorectal cancer (CRC) remains the second most common cause of cancer death in the United States. Screening for CRC reduces mortality through the detection of malignancies at earlier, more treatable stages, as well as through the identification and removal of adenomatous polyps (asymptomatic benign precursor lesions that may lead to CRC). There are a number of tests currently available for screening, such as fecal occult blood testing (FOBT), flexible sigmoidoscopy, and colonoscopy. Screening with FOBT (Hemoccult II) has been shown to reduce CRC mortality by 15% to 33% in randomized controlled trials and screening with more sensitive FOBTs, flexible sigmoidoscopy, colonoscopy or combinations of these tests may reduce the burden of CRC even more. In the absence of adequate clinical trial data on several recommended screening strategies, microsimulation modeling can provide guidance on the risks, benefits, and testing resources required for different screening strategies to reduce the burden of CRC. In July 2002, the US Preventive Services Task Force (USPSTF) concluded that there was sufficient evidence to recommend strongly that all average-risk adults 50 years of age and older should be offered CRC screening. However, the logistics of screening such as the type of screening test, screening interval, and age to stop screening were not evaluated in terms of the balance of benefits and potential harms. The USPSTF has again addressed CRC screening recommendations with a systematic review of the evidence on screening tests. For this assessment, the Task Force requested a decision analysis to project expected outcomes of various CRC screening strategies. Two independent microsimulation modeling groups from the Cancer Intervention and Surveillance Modeling Network (CISNET), funded by the National Cancer Institute, used a comparative modeling approach to compare life-years gained relative to resource use of different CRC screening strategies.
Download or read book Evaluating Test Strategies for Colorectal Cancer Screening Age to Begin Age to Stop and Timing of Screening Intervals written by Ann G. Zauber and published by . This book was released on 2009 with total page 61 pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: The U.S. Preventive Services Task Force requested a decision analysis to inform their update of the recommendations for colorectal cancer (CRC) screening. OBJECTIVE: To assess life-years gained and colonoscopy requirements for CRC screening strategies and identify a set of recommendable screening strategies. DESIGN: Decision analysis using two CRC microsimulation models from the Cancer Intervention and Surveillance Modeling Network. DATA SOURCES: Derived from recent published literature on test characteristics of single use applications of various screening strategies. TARGET POPULATION: U.S. average-risk 40-year-old population. PERSPECTIVE: Societal. TIME HORIZON: Lifetime. INTERVENTIONS: Fecal occult blood tests (FOBTs), flexible sigmoidoscopy, or colonoscopy screening beginning at age 40, 50, or 60 and stopping at age 75 or 85 with screening intervals of 1, 2, or 3 years for FOBT and 5, 10, or 20 years for sigmoidoscopy and colonoscopy. OUTCOME MEASURES: Number of life-years gained compared with no screening and number of colonoscopies and non-colonoscopy tests required. RESULTS OF BASE-CASE ANALYSIS: Beginning screening at age 50 was consistently better than age 60. Lowering the stop age from 85 to 75 decreased life-years gained by 1% to 4%, while colonoscopy use fell by 4% to 15%. Assuming equally high adherence, four strategies provided comparable life-years gained, namely 10-yearly colonoscopy, annual Hemoccult SENSA or fecal immunochemical test, and 5-yearly flexible sigmoidoscopy in conjunction with Hemoccult SENSA every 2 to 3 years. Annual Hemoccult II alone and 5-yearly flexible sigmoidoscopy alone were less effective. RESULTS OF SENSITIVITY ANALYSIS: The results were most sensitive to beginning screening at age 40. LIMITATIONS: Stopping age for screening was based only on chronological age. CONCLUSIONS: Our findings support CRC screening from ages 50 to 75 with annual screening with a high sensitivity FOBT, 10-yearly colonoscopy, or high sensitivity FOBT every 2 to 3 years with a 5-yearly flexible sigmoidoscopy.
Download or read book Evaluating Test Strategies for Colorectal Cancer Screening Age to Begin Age to Stop and Timing of Screening Intervals written by and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Colorectal Cancer Screening written by Joseph Anderson, MD and published by Springer Science & Business Media. This book was released on 2011-04-23 with total page 210 pages. Available in PDF, EPUB and Kindle. Book excerpt: Colorectal Cancer Screening provides a complete overview of colorectal cancer screening, from epidemiology and molecular abnormalities, to the latest screening techniques such as stool DNA and FIT, Computerized Tomography (CT) Colonography, High Definition Colonoscopes and Narrow Band Imaging. As the text is devoted entirely to CRC screening, it features many facts, principles, guidelines and figures related to screening in an easy access format. This volume provides a complete guide to colorectal cancer screening which will be informative to the subspecialist as well as the primary care practitioner. It represents the only text that provides this up to date information about a subject that is continually changing. For the primary practitioner, information on the guidelines for screening as well as increasing patient participation is presentedd. For the subspecialist, information regarding the latest imaging techniques as well as flat adenomas and chromoendoscopy are covered. The section on the molecular changes in CRC will appeal to both groups. The text includes up to date information about colorectal screening that encompasses the entire spectrum of the topic and features photographs of polyps as well as diagrams of the morphology of polyps as well as photographs of CT colonography images. Algorithms are presented for all the suggested guidelines. Chapters are devoted to patient participation in screening and risk factors as well as new imaging technology. This useful volume explains the rationale behind screening for CRC. In addition, it covers the different screening options as well as the performance characteristics, when available in the literature, for each test. This volume will be used by the sub specialists who perform screening tests as well as primary care practitioners who refer patients to be screened for colorectal cancer.
Download or read book Evaluating Test Strategies for Colorectal Cancer Screening Age to Begin Age to Stop and Timing of Screening Intervals written by Ann G. Zauber and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Colorectal Cancer Screening written by Amy B. Knudsen and published by . This book was released on 2021 with total page 275 pages. Available in PDF, EPUB and Kindle. Book excerpt: IMPORTANCE: The U.S. Preventive Services Task Force (USPSTF) is updating its 2016 recommendations for screening for colorectal cancer. OBJECTIVE: To provide the USPSTF updated model-based estimates of the benefits, burden, and harms of colorectal cancer screening strategies that vary by the ages to begin and end screening, screening modality, and screening interval. Analyses also identify strategies that may provide an efficient balance of the colonoscopy burden and the life-years gained (LYG) from screening. DESIGN: Comparative modeling using 3 microsimulation models that simulate outcomes with and without colorectal cancer screening in a hypothetical cohort of previously unscreened average-risk U.S. 40-year-olds with no prior colorectal cancer diagnosis. EXPOSURES: Screening from ages 45, 50 or 55 years to ages 70, 75, 80, or 85 years with fecal immunochemical testing (FIT), multitarget stool DNA testing (FIT-DNA), flexible sigmoidoscopy (SIG) alone or in conjunction with interval FIT, computed tomographic colonography (CTC), or colonoscopy. Screening intervals varied by modality. All persons with an abnormal non-colonoscopy screening test were assumed to undergo follow up colonoscopy. Full adherence with all screening, follow up, and surveillance procedures was assumed. MAIN OUTCOME AND MEASURES: Estimated LYG relative to no screening (benefit), lifetime number of colonoscopies (burden), lifetime number of complications from screening (harms), and balance of incremental burden and benefit (efficiency ratios). Efficient strategies were those that required fewer additional colonoscopies per LYG, relative to other strategies. RESULTS: Estimated LYG from screening ranged from 171 to 381 per 1000 40-year-olds. Lifetime colonoscopy burden ranged from 624 to 6817 per 1000 individuals, and screening complications ranged from 5 to 22 per 1000 individuals. Forty-nine screening strategies were found to be efficient options by all 3 models; in 41 of these strategies, screening began at age 45. No single age to end screening was predominant among the efficient strategies, although the estimated increases in LYG from continuing screening after age 75 were generally small. With the exception of a 5-year interval for CTC, no screening interval was predominant among the efficient strategies for each modality. Among the screening strategies highlighted in the 2016 USPSTF colorectal cancer screening recommendations, lowering the age to begin screening from 50 to 45 was estimated to result in 22 to 27 additional LYG, 2 to 3 fewer colorectal cancer cases, and 0.9 to 1 fewer colorectal cancer death, but it was also estimated to result in 0.1 to 2 additional complications, 161 to 784 additional colonoscopies, and 0 (with colonoscopy) to 3553 additional non-colonoscopy tests over the lifetimes of 1000 persons (ranges are across screening strategies, based on mean estimates across the 3 models). Sensitivity analyses indicated that there was little advantage to customizing screening by race and sex; the estimated numbers of LYG, colonoscopies, and complications were similar across race-sex groups, as were the efficient strategies and their ratios. Scenario analyses demonstrated that efficient strategies were similar across 3 scenarios for the population risk of colorectal cancer, including one in which the assumed risk increase was less conservative than the assumption for the base-case analysis. The effect of imperfect adherence on outcomes was estimated by comparing strategies with different ages to begin screening (to examine delays in uptake) or with strategies with different screening intervals (to examine delays in rescreening). For example, the models estimated that extending the interval of repeat colonoscopy screening from 10 to 15 years would result in a loss of 22 to 38 life years per 1000, and extending the interval of FIT screening from annual to triennial testing would result in a loss of 28 to 41 life years per 1000. LIMITATIONS: The models do not simulate the serrated polyp pathway to CRC. The models assume that the observed increase in colorectal cancer incidence among 20- to 44-year-olds in recent years is a cohort effect, and that the increase in risk will be carried forward as individuals age. They further assume that the increase in incidence is driven by an increased risk of developing adenomas, as opposed to faster or more frequent progression of adenomas to malignancy. CONCLUSIONS: This comparative modeling study suggests that colorectal cancer screening may lead to sizable reductions in the lifetime risks of developing and dying from colorectal cancer. Many screening strategies are estimated to provide an efficient balance of the burden and benefit of screening; these strategies encompass a range of screening modalities, intervals, and ages. However, when the benefits of screening are measured by the number of LYG, most of the efficient screening strategies identified by all 3 models specified screening starting at age 45. Starting screening at age 45 was generally estimated to result in more LYG and fewer colorectal cancer cases and deaths than similar strategies with screening starting at age 50 or age 55, albeit with a higher lifetime burden of both colonoscopy and non-colonoscopy testing and slightly higher lifetime risks of complications.
Download or read book European Guidelines for Quality Assurance in Colorectal Cancer Screening and Diagnosis written by Nereo Segnan and published by . This book was released on 2010 with total page 452 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recoge: 1. Introduction -- 2. Organisation -- Guiding principles for organising a colorectal cancer screening programme -- 3. Evaluation and interpretation of screening outcomes -- 4. Faecal occult blood testing -- 5. Quality assurance in endoscopy in colorectal cancer screening and diagnosis -- 6. Professional requirements and training -- 7. Quality assurance in pathology in colorectal cancer screening and diagnosis -- 8. Management of lesions detected in colorectal cancer screening -- 9. Colonoscopic surveillance following adenoma removal --10. Communication -- Appendices.
Download or read book Implementing Colorectal Cancer Screening written by Institute of Medicine and published by National Academies Press. This book was released on 2009-01-01 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt: The IOM's National Cancer Policy Board estimated in 2003 that even modest efforts to implement known tactics for cancer prevention and early detection could result in up to a 29 percent drop in cancer deaths in about 20 years. The IOM's National Cancer Policy Forum, which succeeded the Board after it was disbanded in 2005, continued the Board's work to outline ways to increase screening in the U.S. On February 25 and 26, 2008, the Forum convened a workshop to discuss screening for colorectal cancer. Colorectal cancer screening remains low, despite strong evidence that screening prevents deaths. With the aim to make recommended colorectal cancer screening more widespread, the workshop discussed steps to be taken at the clinic, community, and health system levels. Workshop speakers, representing a broad spectrum of leaders in the field, identified major barriers to increased screening and described strategies to overcome these obstacles. This workshop summary highlights the information presented, as well as the subsequent discussion about actions needed to increase colorectal screening and, ultimately, to prevent more colorectal cancer deaths.
Download or read book Costs and effectiveness of colorectal cancer screening in the elderly written by Health Program Office of Technology Assessment U.S. Congress Washington, DC 20510-8025 and published by DIANE Publishing. This book was released on 1990 with total page 63 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book New Methodological Approaches to Assessing Colorectal Cancer Screening written by Resa Marie Jones and published by . This book was released on 2004 with total page 432 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Colorectal Cancer Screening written by Han-Mo Chiu and published by Springer Nature. This book was released on 2020-11-20 with total page 145 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book offers a self-contained review of the theoretical and practical basis of colorectal cancer screening. Colorectal cancer is currently the fourth leading cause of cancer deaths worldwide and represents a significant burden for both public health and health care systems. However, colorectal cancer deaths can be prevented using effective screening, and many countries and regions have launched population colorectal cancer screening programs. This book covers various essential aspects of colorectal cancer screening, including the epidemiology of colorectal cancer, the various screening and diagnostic tests or exams, quality issues in colorectal cancer screening, necessary infrastructures, the evaluation of effectiveness, and economic appraisals of screening programs. Focusing on organized screening, in which various quality indicators can easily monitored and effectiveness is more likely to be evaluated, it discusses the basics of screening theory and the natural history of colorectal neoplasms, to help readers understand the rationale behind cancer screening. Lastly, it features international consensus and guidelines on colorectal cancer screening to highlight the current trends in the field. This comprehensive book on recent technological developments and conceptual advances in colorectal cancer screening is a valuable resource for public health workers and clinicians alike.
Download or read book Fulfilling the Potential of Cancer Prevention and Early Detection written by National Research Council and published by National Academies Press. This book was released on 2003-05-07 with total page 564 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.
Download or read book Costs and Effectiveness of Colorectal Cancer Screening in the Elderly written by and published by . This book was released on 1990 with total page 68 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Colorectal Cancer Screening written by and published by . This book was released on 1998 with total page 168 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Colorectal Cancer Screening written by Aasma Shaukat and published by Springer. This book was released on 2015-03-14 with total page 210 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume provides a comprehensive overview of quality metrics and methods used to improve quality for all major modalities of CRC screening. It introduces the readers to the evidence of effectiveness behind various CRC screening modalities: stool-based tests (Fecal Occult Blood, Fecal Immunochemical and Fecal DNA tests), flexible sigmoidoscopy, colonoscopy and CT colonography. In-depth chapters review the latest guidelines for CRC screening, compare differences among the five major national guidelines, and highlight the need for valid quality and cost indicators. While the main focus of this volume is on colonoscopy, since most quality indicators and analyses have focused on this modality of screening and surveillance, one chapter is devoted to quality indicators of other screening modalities. Differences between process and outcome measures are also highlighted and a small but valid set of recommended national measures are listed. Written by experts in the field, Colorectal Cancer Screening: Quality and Benchmarks is an important and useful resource written for gastroenterologists, primary care physicians, general and colorectal surgeons, family physicians, and investigators with research focus in screening and quality metrics.
