PMID- 25783458
OWN - NLM
STAT- MEDLINE
DCOM- 20160406
LR  - 20181202
IS  - 1573-7225 (Electronic)
IS  - 0957-5243 (Print)
IS  - 0957-5243 (Linking)
VI  - 26
IP  - 6
DP  - 2015 Jun
TI  - Incremental benefits of screening colonoscopy over sigmoidoscopy in average-risk 
      populations: a model-driven analysis.
PG  - 859-70
LID - 10.1007/s10552-015-0559-7 [doi]
AB  - PURPOSE: Screening colonoscopy and flexible sigmoidoscopy (FSG) reduce the risk 
      of colorectal cancer (CRC), but the magnitude and duration of protection, 
      particularly against right-sided cancer, remain uncertain. We computed the 
      incremental benefit of colonoscopy over FSG using a validated mathematical model, 
      which reflects colorectal neoplasia growth characteristics while allowing 
      uncertainty in endoscopic detection and removal of adenomas. METHODS: We 
      calibrated models of CRC incidence within a multistage clonal expansion framework 
      to data from: (1) San Francisco-Oakland SEER registry (reference population) and 
      (2) FSG long-term follow-up data from 50,757 individuals after a negative FSG in 
      the Kaiser Permanente system. We compared the residual CRC risks after FSG with 
      full-length colonoscopy. RESULTS: Our model mirrors trial data with 10-year CRC 
      risk reductions after FSG screening at age 50 years of approximately one-third; 
      the optimal age for a 'once-only' FSG exam was between ages 50 and 60 years; and 
      the greater benefit was for men compared with women. There were considerable 
      incremental gains in reduction in CRC risk by colonoscopy compared with FSG with 
      the greatest benefit for screening colonoscopy at age 50 years. These results 
      held up against lowering the right-sided adenoma detection sensitivity by 30%, as 
      well as reducing the curative efficacy of polypectomy throughout the colon. 
      CONCLUSIONS: Mathematical modeling of CRC screening, which takes account of 
      important aspects of tumor biology, demonstrates superior risk reductions by 
      colonoscopy over FSG. Our predictions provide further rationale for recommending 
      screening colonoscopy in average-risk populations before the age of 60.
FAU - Jeon, Jihyoun
AU  - Jeon J
AD  - Program of Biostatistics and Biomathematics, Fred Hutchinson Cancer Research 
      Center, 1100 Fairview Ave N, M2-B500, Seattle, WA, 98109-1024, USA, 
      jhjeon@fhcrc.org.
FAU - Meza, Rafael
AU  - Meza R
FAU - Hazelton, William D
AU  - Hazelton WD
FAU - Renehan, Andrew G
AU  - Renehan AG
FAU - Luebeck, E Georg
AU  - Luebeck EG
LA  - eng
GR  - R01 CA107028/CA/NCI NIH HHS/United States
GR  - R03 CA092767/CA/NCI NIH HHS/United States
GR  - S10 OD020069/OD/NIH HHS/United States
GR  - R01CA107028/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20150318
PL  - Netherlands
TA  - Cancer Causes Control
JT  - Cancer causes & control : CCC
JID - 9100846
SB  - IM
MH  - Adenoma/*diagnosis/epidemiology
MH  - Aged
MH  - Aged, 80 and over
MH  - Colonoscopy/*methods
MH  - Colorectal Neoplasms/*diagnosis/epidemiology
MH  - Early Detection of Cancer/*methods
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Mass Screening/*methods
MH  - Middle Aged
MH  - Models, Theoretical
MH  - San Francisco
MH  - Sigmoidoscopy/*methods
PMC - PMC4646080
MID - NIHMS735165
COIS- Disclose any potential conflicts of interest: The authors have no conflict of 
      interest.
EDAT- 2015/03/19 06:00
MHDA- 2016/04/07 06:00
PMCR- 2016/06/01
CRDT- 2015/03/19 06:00
PHST- 2014/07/30 00:00 [received]
PHST- 2015/03/11 00:00 [accepted]
PHST- 2015/03/19 06:00 [entrez]
PHST- 2015/03/19 06:00 [pubmed]
PHST- 2016/04/07 06:00 [medline]
PHST- 2016/06/01 00:00 [pmc-release]
AID - 10.1007/s10552-015-0559-7 [doi]
PST - ppublish
SO  - Cancer Causes Control. 2015 Jun;26(6):859-70. doi: 10.1007/s10552-015-0559-7. 
      Epub 2015 Mar 18.