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024 7 _ |a 10.1002/ijc.33437
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024 7 _ |a 1097-0215
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100 1 _ |a Heisser, Thomas
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245 _ _ |a Effects of Screening for Colorectal Cancer: Development, Documentation and Validation of a Multistate Markov Model.
260 _ _ |a Bognor Regis
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500 _ _ |a 2021 Apr 15;148(8):1973-1981#EA:C070#LA:C070#
520 _ _ |a Simulation models are a powerful tool to overcome gaps of evidence needed to inform medical decision making. Here, we present development and application of a multistate Markov model to simulate effects of colorectal cancer (CRC) screening, along with a thorough assessment of the model's ability to reproduce real-life outcomes. Firstly, we provide a comprehensive documentation of the model development, structure and assumptions. Secondly, to assess the model's external validity, we compared model-derived cumulative incidence and prevalences of colorectal neoplasms to (1) results from KolosSal, a study in German screening colonoscopy participants, (2) registry-based estimates of CRC incidence in Germany, and (3) outcome patterns of randomized sigmoidoscopy screening studies. We found that (1) more than 90% of observed prevalences in the KolosSal study were within the 95% confidence intervals of the model-predicted neoplasm prevalences; (2) the 15-year cumulative CRC incidences estimated by simulations for the German population deviated by 0.0-0.2 percent units in men and 0.0-0.3 percent units in women when compared to corresponding registry-derived estimates; and (3) the time course of cumulative CRC incidence and mortality in the modelled intervention group and control group closely resembles the time course reported from sigmoidoscopy screening trials. Summarized, our model adequately predicted colorectal neoplasm prevalences and incidences in a German population for up to 25 years, with estimated patterns of the effect of screening colonoscopy resembling those seen in registry data and real-world studies. This suggests that the model may represent a valid tool to assess the comparative effectiveness of CRC screening strategies. This article is protected by copyright. All rights reserved.
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650 _ 7 |a colorectal cancer
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650 _ 7 |a screening
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650 _ 7 |a validation
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700 1 _ |a Hoffmeister, Michael
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700 1 _ |a Brenner, Hermann
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773 _ _ |a 10.1002/ijc.33437
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