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000290491 1001_ $$00009-0001-4791-0613$$aZaika, Viktor$$b0
000290491 245__ $$aOptimal timing of a colonoscopy screening schedule depends on adenoma detection, adenoma risk, adherence to screening and the screening objective: A microsimulation study.
000290491 260__ $$aSan Francisco, California, US$$bPLOS$$c2024
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000290491 520__ $$aColonoscopy-based screening provides protection against colorectal cancer (CRC), but the optimal starting age and time intervals of screening colonoscopies are unknown. We aimed to determine an optimal screening schedule for the US population and its dependencies on the objective of screening (life years gained or incidence, mortality, or cost reduction) and the setting in which screening is performed. We used our established open-source microsimulation model CMOST to calculate optimized colonoscopy schedules with one, two, three or four screening colonoscopies between 20 and 90 years of age. A single screening colonoscopy was most effective in reducing life years lost from CRC when performed at 55 years of age. Two, three and four screening colonoscopy schedules saved a maximum number of life years when performed between 49-64 years; 44-69 years; and 40-72 years; respectively. However, for maximum incidence and mortality reduction, screening colonoscopies needed to be scheduled 4-8 years later in life. The optimum was also influenced by adenoma detection efficiency with lower values for these parameters favoring a later starting age of screening. Low adherence to screening consistently favored a later start and an earlier end of screening. In a personalized approach, optimal screening would start earlier for high-risk patients and later for low-risk individuals. In conclusion, our microsimulation-based approach supports colonoscopy screening schedule between 45 and 75 years of age but the precise timing depends on the objective of screening, as well as assumptions regarding individual CRC risk, efficiency of adenoma detection during colonoscopy and adherence to screening.
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000290491 650_2 $$2MeSH$$aHumans
000290491 650_2 $$2MeSH$$aColonoscopy
000290491 650_2 $$2MeSH$$aMiddle Aged
000290491 650_2 $$2MeSH$$aAdenoma: diagnosis
000290491 650_2 $$2MeSH$$aAged
000290491 650_2 $$2MeSH$$aEarly Detection of Cancer: methods
000290491 650_2 $$2MeSH$$aAdult
000290491 650_2 $$2MeSH$$aColorectal Neoplasms: diagnosis
000290491 650_2 $$2MeSH$$aMale
000290491 650_2 $$2MeSH$$aFemale
000290491 650_2 $$2MeSH$$aAged, 80 and over
000290491 650_2 $$2MeSH$$aPatient Compliance
000290491 650_2 $$2MeSH$$aTime Factors
000290491 650_2 $$2MeSH$$aComputer Simulation
000290491 650_2 $$2MeSH$$aMass Screening: methods
000290491 650_2 $$2MeSH$$aYoung Adult
000290491 7001_ $$aPrakash, Meher K$$b1
000290491 7001_ $$0P:(DE-He78)d2944f54ead34dbf6fb03e359225a1b9$$aCheng, Chih-Yuan$$b2
000290491 7001_ $$0P:(DE-He78)1f315d09721b91091df1ba78eb65cbaf$$aSchlander, Michael$$b3$$udkfz
000290491 7001_ $$aLang, Brian M$$b4
000290491 7001_ $$00000-0002-0573-6119$$aBeerenwinkel, Niko$$b5
000290491 7001_ $$aSonnenberg, Amnon$$b6
000290491 7001_ $$aKrupka, Niklas$$b7
000290491 7001_ $$00000-0002-8719-5175$$aMisselwitz, Benjamin$$b8
000290491 7001_ $$aPoleszczuk, Jan$$b9
000290491 773__ $$0PERI:(DE-600)2267670-3$$a10.1371/journal.pone.0304374$$gVol. 19, no. 5, p. e0304374 -$$n5$$pe0304374 -$$tPLOS ONE$$v19$$x1932-6203$$y2024
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