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@ARTICLE{Chen:141865,
author = {C. Chen$^*$ and C. Stock$^*$ and M. Hoffmeister$^*$ and H.
Brenner$^*$},
title = {{H}ow long does it take until the effects of endoscopic
screening on colorectal cancer mortality are fully
disclosed?: a {M}arkov model study.},
journal = {International journal of cancer},
volume = {143},
number = {11},
issn = {0020-7136},
address = {Bognor Regis},
publisher = {Wiley-Liss},
reportid = {DKFZ-2018-02122},
pages = {2718 - 2724},
year = {2018},
abstract = {A 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.},
cin = {C070 / G110},
ddc = {610},
cid = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331},
pnm = {313 - Cancer risk factors and prevention (POF3-313)},
pid = {G:(DE-HGF)POF3-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:29978478},
doi = {10.1002/ijc.31716},
url = {https://inrepo02.dkfz.de/record/141865},
}