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@ARTICLE{Zaika:290491,
      author       = {V. Zaika and M. K. Prakash and C.-Y. Cheng$^*$ and M.
                      Schlander$^*$ and B. M. Lang and N. Beerenwinkel and A.
                      Sonnenberg and N. Krupka and B. Misselwitz and J.
                      Poleszczuk},
      title        = {{O}ptimal timing of a colonoscopy screening schedule
                      depends on adenoma detection, adenoma risk, adherence to
                      screening and the screening objective: {A} microsimulation
                      study.},
      journal      = {PLOS ONE},
      volume       = {19},
      number       = {5},
      issn         = {1932-6203},
      address      = {San Francisco, California, US},
      publisher    = {PLOS},
      reportid     = {DKFZ-2024-01118},
      pages        = {e0304374 -},
      year         = {2024},
      abstract     = {Colonoscopy-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.},
      keywords     = {Humans / Colonoscopy / Middle Aged / Adenoma: diagnosis /
                      Aged / Early Detection of Cancer: methods / Adult /
                      Colorectal Neoplasms: diagnosis / Male / Female / Aged, 80
                      and over / Patient Compliance / Time Factors / Computer
                      Simulation / Mass Screening: methods / Young Adult},
      cin          = {C100},
      ddc          = {610},
      cid          = {I:(DE-He78)C100-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:38787836},
      pmc          = {pmc:PMC11125540},
      doi          = {10.1371/journal.pone.0304374},
      url          = {https://inrepo02.dkfz.de/record/290491},
}