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@ARTICLE{Heisser:288860,
      author       = {T. Heisser$^*$ and D. Sergeev$^*$ and M. Hoffmeister$^*$
                      and H. Brenner$^*$},
      title        = {{C}ontributions of early detection and cancer prevention to
                      colorectal cancer mortality reduction by screening
                      colonoscopy: a validated modelling study.},
      journal      = {Gastrointestinal endoscopy},
      volume       = {100},
      number       = {4},
      issn         = {0016-5107},
      address      = {New York, NY},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2024-00507},
      pages        = {710-717.e9},
      year         = {2024},
      note         = {#EA:C070#LA:C070#LA:C120# / 2024 Oct;100(4):710-717.e9},
      abstract     = {Screening colonoscopy, recommended every ten years, reduces
                      mortality from colorectal cancer (CRC) by early detection of
                      prevalent but undiagnosed CRC, as well as by prevention of
                      CRC by removal of precursor lesions. The aim of this study
                      was to assess the relative contribution of both components
                      to total CRC mortality reduction over time.Using a validated
                      multistate Markov model, we simulated hypothetical cohorts
                      of 100,000 individuals aged 55-64 with and without use of
                      screening at baseline. Main outcomes included proportions of
                      prevented CRC deaths arising from (asymptomatic) CRC already
                      prevalent at baseline and from newly developed CRC during
                      15-years of follow-up, and mortality rate ratios of screened
                      versus unscreened groups over time.Early detection of
                      prevalent cases accounted for $52\%,$ $30\%$ and $18\%$ of
                      deaths prevented by screening colonoscopy within 5, 10 and
                      15 years, respectively. Relative reduction of mortality was
                      estimated to be much larger for mortality from incident
                      cancers than for mortality from cancers that were already
                      present and early detected at screening endoscopy and for
                      total CRC mortality (i.e., $88\%$ versus $67\%$ and $79\%$
                      within 10 years from screening).Reduction of CRC mortality
                      mainly arises from early detection of prevalent cancers
                      during the early years after screening colonoscopy, but
                      prevention of incident cases accounts for the majority of
                      prevented deaths in the longer run. Prevention of incident
                      cases leads to sustained strong reduction of colorectal
                      cancer mortality, possibly warranting an extension of
                      screening intervals.},
      keywords     = {colonoscopy (Other) / colorectal cancer (Other) / endoscopy
                      (Other) / modelling (Other) / mortality (Other) / screening
                      (Other)},
      cin          = {C070 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:38462054},
      doi          = {10.1016/j.gie.2024.03.010},
      url          = {https://inrepo02.dkfz.de/record/288860},
}