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Population-level impact of the BMJ Rapid Recommendation for colorectal cancer screening: a microsimulation analysis.
van Duuren, Luuk A; Bulliard, Jean-Luc; Mohr, Ella; van den Puttelaar, Rosita; Plys, Ekaterina; Brändle, Karen; Corley, Douglas A; Froehlich, Florian; Selby, Kevin; Lansdorp-Vogelaar, Iris.
Afiliación
  • van Duuren LA; Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland l.vanduuren@erasmusmc.nl.
  • Bulliard JL; Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Mohr E; Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.
  • van den Puttelaar R; Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.
  • Plys E; Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Brändle K; Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.
  • Corley DA; Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.
  • Froehlich F; Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
  • Selby K; Department of Gastroenterology, University of Basel, Basel, Switzerland.
  • Lansdorp-Vogelaar I; Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.
BMJ Open Gastroenterol ; 11(1)2024 May 09.
Article en En | MEDLINE | ID: mdl-38724254
ABSTRACT

OBJECTIVE:

In 2019, a BMJ Rapid Recommendation advised against colorectal cancer (CRC) screening for adults with a predicted 15-year CRC risk below 3%. Using Switzerland as a case study, we estimated the population-level impact of this recommendation.

DESIGN:

We predicted the CRC risk of all respondents to the population-based Swiss Health Survey. We derived the distribution of risk-based screening start age, assuming predicted risk was calculated every 5 years between ages 25 and 70 and screening started when this risk exceeded 3%. Next, the MISCAN-Colon microsimulation model evaluated biennial faecal immunochemical test (FIT) screening with this risk-based start age. As a comparison, we simulated screening initiation based on age and sex.

RESULTS:

Starting screening only when predicted risk exceeded 3% meant 82% of women and 90% of men would not start screening before age 65 and 60, respectively. This would require 43%-57% fewer tests, result in 8%-16% fewer CRC deaths prevented and yield 19%-33% fewer lifeyears gained compared with screening from age 50. Screening women from age 65 and men from age 60 had a similar impact as screening only when predicted risk exceeded 3%.

CONCLUSION:

With the recommended risk prediction tool, the population impact of the BMJ Rapid Recommendation would be similar to screening initiation based on age and sex only. It would delay screening initiation by 10-15 years. Although halving the screening burdens, screening benefits would be reduced substantially compared with screening initiation at age 50. This suggests that the 3% risk threshold to start CRC screening might be too high.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Detección Precoz del Cáncer / Sangre Oculta Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: BMJ Open Gastroenterol Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Detección Precoz del Cáncer / Sangre Oculta Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: BMJ Open Gastroenterol Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido