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000143557 1001_ $$0P:(DE-He78)03c284fb24dee4c82200ce43e1e0340f$$aChen, Hongda$$b0$$eFirst author$$udkfz
000143557 245__ $$aOptimal age for screening colonoscopy: a modeling study.g110
000143557 260__ $$aNew York, NY$$bElsevier$$c2019
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000143557 520__ $$aRecent guidelines on colorectal cancer (CRC) screening recommend starting screening earlier than before. We performed a simulation study to examine and compare the optimal ages to have once-only screening colonoscopy and repeated colonoscopies.A Markov model was set up using data from the German national screening colonoscopy registry to simulate the natural history of the adenoma-carcinoma process. CRC deaths and years of potential life lost (YPLL) for a hypothetical unscreened 50-year-old German population were estimated for a single screening colonoscopy or 2 or 3 screening colonoscopies with 10-year intervals at various ages.One single screening colonoscopy performed between 50 and 65 years of age was expected to reduce CRC death by 49% to 69% and YPLL by 51% to 68%. An inverted U-shaped association was found between screening age and proportion of CRC deaths or YPLL prevented. The optimal age for once-only colonoscopy that yielded the highest reductions in YPLL was around 54 years for men and 56 years for women. Estimates were approximately 6 to 8 years higher when proportions of CRC deaths prevented were examined. For 2 or 3 screening colonoscopies, the optimal starting age fell to around 50 years or even younger for both genders.Based on the YPLL estimates, in a high CRC incidence and high life expectancy country like Germany, the optimal age for once-only screening colonoscopy is around 55 years and possibly slightly younger for men than for women. When 2 or more screening colonoscopies are offered with 10-year intervals, screening should start at age 50 at the latest or possibly even younger for both genders.
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000143557 7001_ $$0P:(DE-He78)908880209a64ea539ae8dc5fdb7e0a91$$aStock, Christian$$b1$$udkfz
000143557 7001_ $$0P:(DE-He78)6c5d058b7552d071a7fa4c5e943fff0f$$aHoffmeister, Michael$$b2$$udkfz
000143557 7001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Hermann$$b3$$eLast author$$udkfz
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