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000141865 1001_ $$0P:(DE-He78)b3928caa1d0865f09ffc5cf5e7683da6$$aChen, Chen$$b0$$eFirst author$$udkfz
000141865 245__ $$aHow long does it take until the effects of endoscopic screening on colorectal cancer mortality are fully disclosed?: a Markov model study.
000141865 260__ $$aBognor Regis$$bWiley-Liss$$c2018
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000141865 520__ $$aA recent randomized trial has suggested persisting protection from colorectal cancer (CRC) incidence and mortality of a single flexible sigmoidoscopy for up to 17 years and possibly beyond. We performed a simulation study to explore the time course and magnitude of protection provided by screening colonoscopy against CRC death over 25 years. Using data from the German national screening colonoscopy registry, a multistate Markov model was set up based on the adenoma-carcinoma pathway to estimate cumulative CRC mortality when different proportions of the population have a single screening colonoscopy at age 55, or two screening colonoscopies at ages 55 and 65. Cumulative CRC mortality continuously increased with age and reached 2.6 and 1.7% at age 80 in the absence of screening for men and women, respectively. A single colonoscopy at age 55, even with limited uptake, would lead to much lower cumulative mortality (0.7% for men and 0.5% for women at age 80 under 100% uptake). Relative mortality reduction continued to increase over more than 10 years and reached the maximum around 12-13 years after screening. Absolute risk reduction steadily increased throughout follow-up and more than half of the total risk reduction would occur between 15-25 years. A repeat colonoscopy 10 years later further enhanced the effects and cumulative mortality remained at 0.1-0.2% under 100% uptake. Even a single (once-only) screening colonoscopy has the potential to prevent most of CRC mortalities. Protective effects are expected to be long-lasting and to become fully manifest after more than two decades from screening.
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000141865 7001_ $$0P:(DE-He78)908880209a64ea539ae8dc5fdb7e0a91$$aStock, Christian$$b1$$udkfz
000141865 7001_ $$0P:(DE-He78)6c5d058b7552d071a7fa4c5e943fff0f$$aHoffmeister, Michael$$b2$$udkfz
000141865 7001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Hermann$$b3$$eLast author$$udkfz
000141865 773__ $$0PERI:(DE-600)1474822-8$$a10.1002/ijc.31716$$gVol. 143, no. 11, p. 2718 - 2724$$n11$$p2718 - 2724$$tInternational journal of cancer$$v143$$x0020-7136$$y2018
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