The impact of the rising colorectal cancer incidence in young adults on the optimal age to start screening: Microsimulation analysis I to inform the American Cancer Society colorectal cancer screening guideline
Elisabeth F.P. Peterse,Reinier G.S. Meester,Rebecca L. Siegel,Jennifer C. Chen,Andrea Dwyer,Dennis J. Ahnen,Robert A. Smith,Ann G. Zauber,Iris Lansdorp-Vogelaar +8 more
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1 of 2 microsimulation analyses to inform the update of the American Cancer Society CRC screening guideline, the authors re‐evaluated the optimal screening strategies in light of the increase in CRC diagnosed in young adults.Abstract:
Background In 2016, the Microsimulation Screening Analysis-Colon (MISCAN-Colon) model was used to inform the US Preventive Services Task Force colorectal cancer (CRC) screening guidelines. In this study, 1 of 2 microsimulation analyses to inform the update of the American Cancer Society CRC screening guideline, the authors re-evaluated the optimal screening strategies in light of the increase in CRC diagnosed in young adults. Methods The authors adjusted the MISCAN-Colon model to reflect the higher CRC incidence in young adults, who were assumed to carry forward escalated disease risk as they age. Life-years gained (LYG; benefit), the number of colonoscopies (COL; burden) and the ratios of incremental burden to benefit (efficiency ratio [ER] = ΔCOL/ΔLYG) were projected for different screening strategies. Strategies differed with respect to test modality, ages to start (40 years, 45 years, and 50 years) and ages to stop (75 years, 80 years, and 85 years) screening, and screening intervals (depending on screening modality). The authors then determined the model-recommended strategies in a similar way as was done for the US Preventive Services Task Force, using ER thresholds in accordance with the previously accepted ER of 39. Results Because of the higher CRC incidence, model-predicted LYG from screening increased compared with the previous analyses. Consequently, the balance of burden to benefit of screening improved and now 10-yearly colonoscopy screening starting at age 45 years resulted in an ER of 32. Other recommended strategies included fecal immunochemical testing annually, flexible sigmoidoscopy screening every 5 years, and computed tomographic colonography every 5 years. Conclusions This decision-analysis suggests that in light of the increase in CRC incidence among young adults, screening may be offered earlier than has previously been recommended. Cancer 2018;124:2964-73. © 2018 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.read more
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Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society
Andrew M.D. Wolf,Elizabeth T. H. Fontham,Timothy R. Church,Christopher R. Flowers,Carmen Guerra,Samuel J. LaMonte,Ruth Etzioni,Matthew T. McKenna,Kevin C. Oeffinger,Ya Chen Tina Shih,Louise C. Walter,Kimberly S. Andrews,Otis W. Brawley,Durado Brooks,Stacey A. Fedewa,Deana Manassaram-Baptiste,Rebecca L. Siegel,Richard C. Wender,Robert A. Smith +18 more
TL;DR: This guideline update used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evaluation of the age to begin screening by race and sex and additional modeling that incorporates changes in US CRC incidence.
Journal ArticleDOI
Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening
Robert A. Smith,Kimberly S. Andrews,Durado Brooks,Stacey A. Fedewa,Deana Manassaram-Baptiste,Debbie Saslow,Otis W. Brawley,Richard C. Wender +7 more
TL;DR: The new American Cancer Society colorectal cancer screening guidelines are summarized and a clarification in the language of the 2013 lung cancer screening guideline is included.
Journal ArticleDOI
Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years
Fanny E. Vuik,Stella A. V. Nieuwenburg,Marc Bardou,Iris Lansdorp-Vogelaar,Mário Dinis-Ribeiro,Maria José Bento,Vesna Zadnik,Maria Pellise,Laura Esteban,Michal F. Kaminski,Stepan Suchanek,Ondřej Ngo,Ondřej Májek,Marcis Leja,Ernst J. Kuipers,Manon C.W. Spaander +15 more
TL;DR: European trends in CRC incidence and mortality in subjects younger than 50 years, consistent with an age-cohort phenomenon, are analyzed and screening guidelines may need to be reconsidered.
Journal ArticleDOI
Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening.
Robert A. Smith,Kimberly S. Andrews,Durado Brooks,Stacey A. Fedewa,Deana Manassaram-Baptiste,Debbie Saslow,Richard C. Wender +6 more
TL;DR: The current American Cancer Society cancer screening guidelines are summarized, and the most current data from the National Health Interview Survey are provided on the utilization of cancer screening for men and women and on the adherence of men andWomen to multiple recommended screening tests.
Journal ArticleDOI
Global patterns and trends in colorectal cancer incidence in young adults
Rebecca L. Siegel,Lindsey A. Torre,Isabelle Soerjomataram,Richard B. Hayes,Freddie Bray,Thomas K Weber,Ahmedin Jemal +6 more
TL;DR: CRC incidence increased exclusively in young adults in nine high-income countries spanning three continents, potentially signalling changes in early-life exposures that influence large bowel carcinogenesis.
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Rebecca L. Siegel,Kimberly D. Miller,Stacey A. Fedewa,Dennis J. Ahnen,Reinier G.S. Meester,Afsaneh Barzi,Ahmedin Jemal +6 more
TL;DR: Overall CRC incidence in individuals ages ≥50 years declined from 2009 to 2013 in every state except Arkansas, with the decrease exceeding 5% annually in 7 states; however, rectal tumor incidence in those ages 50 to 64 years was stable in most states.
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Bernard Levin,David A. Lieberman,Beth McFarland,Kimberly S. Andrews,Durado Brooks,John H. Bond,Chiranjeev Dash,Francis M. Giardiello,Seth N. Glick,David W. Johnson,C. Daniel Johnson,Theodore R. Levin,Perry J. Pickhardt,Douglas K. Rex,Robert A. Smith,Alan G. Thorson,Sidney J. Winawer +16 more
TL;DR: Clinicians should be prepared to offer patients a choice between a screening test that is effective at both early cancer detection and cancer prevention through the detection and removal of polyps and those that can detect cancer early and also can detect adenomatous polyps.
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Kirsten Bibbins-Domingo,David C. Grossman,Susan J. Curry,Karina W. Davidson,John W. Epling,Francisco A.R. Garcia,Matthew W. Gillman,Diane M. Harper,Alex R. Kemper,Alex H. Krist,Ann E. Kurth,C. Seth Landefeld,Carol M. Mangione,Douglas K Owens,Douglas K Owens,William R. Phillips,Maureen G. Phipps,Michael Pignone,Albert L. Siu,Albert L. Siu +19 more
TL;DR: It is concluded with high certainty that screening for colorectal cancer in average-risk, asymptomatic adults aged 50 to 75 years is of substantial net benefit.
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TL;DR: This update focused on screening in asymptomatic, average-risk adults (aged 50 years), but also considered previous recommendations for persons at increased or high risk for CRC, including persons with a history of adenomatous polyps or a previous curative resection of CRC.
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Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine
Gillian D Sanders,Peter J. Neumann,Anirban Basu,Dan W. Brock,David Feeny,Murray Krahn,Karen M. Kuntz,David O. Meltzer,Douglas K Owens,Lisa A. Prosser,Joshua A. Salomon,Mark Sculpher,Thomas A Trikalinos,Louise B. Russell,Joanna E. Siegel,Theodore G. Ganiats +15 more
TL;DR: The Second Panel on Cost-Effectiveness in Health and Medicine reviewed the current status of the field of cost-effectiveness analysis and developed a new set of recommendations, including the recommendation to perform analyses from 2 reference case perspectives and to provide an impact inventory to clarify included consequences.
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