TY - JOUR AU - Cheng, Chih-Yuan AU - Calderazzo, Silvia AU - Schramm, Christoph AU - Schlander, Michael TI - Modeling the Natural History and Screening Effects of Colorectal Cancer Using Both Adenoma and Serrated Neoplasia Pathways: The Development, Calibration, and Validation of a Discrete Event Simulation Model. JO - Medical decision making policy & practice VL - 8 IS - 1 SN - 2381-4683 CY - London PB - Sage Publishing M1 - DKFZ-2023-00202 SP - 238146832211457 - PY - 2023 N1 - #EA:C100#LA:C100# AB - Background. Existing colorectal cancer (CRC) screening models mostly focus on the adenoma pathway of CRC development, overlooking the serrated neoplasia pathway, which might result in overly optimistic screening predictions. In addition, Bayesian inference methods have not been widely used for model calibration. We aimed to develop a CRC screening model accounting for both pathways, calibrate it with approximate Bayesian computation (ABC) methods, and validate it with large CRC screening trials. Methods. A discrete event simulation (DES) of the CRC natural history (DECAS) was constructed using the adenoma and serrated pathways in R software. The model simulates CRC-related events in a specific birth cohort through various natural history states. Calibration took advantage of 74 prevalence data points from the German screening colonoscopy program of 5.2 million average-risk participants using an ABC method. CRC incidence outputs from DECAS were validated with the German national cancer registry data; screening effects were validated using 17-y data from the UK Flexible Sigmoidoscopy Screening sigmoidoscopy trial and a German screening colonoscopy cohort study. Results. The Bayesian calibration rendered 1,000 sets of posterior parameter samples. With the calibrated parameters, the observed age- and sex-specific CRC prevalences from the German registries were within the 95 KW - bayesian calibration (Other) KW - colorectal cancer (Other) KW - discrete event simulation (Other) KW - screening (Other) KW - serrated polyps (Other) LB - PUB:(DE-HGF)16 C6 - pmid:36698854 C2 - pmc:PMC9869210 DO - DOI:10.1177/23814683221145701 UR - https://inrepo02.dkfz.de/record/212517 ER -