Optimal age for screening colonoscopy: a modeling study
Background and Aims - Recent guidelines on colorectal cancer (CRC) screening recommend starting screening earlier than before. We performed a simulation study to examine and compare the optimal ages to have once-only screening colonoscopy and repeated colonoscopies. - Methods - A Markov model was se...
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| Main Authors: | , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
9 January 2019
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| In: |
Gastrointestinal endoscopy
Year: 2019, Volume: 89, Issue: 5, Pages: 1017-1025.e12 |
| ISSN: | 1097-6779 |
| DOI: | 10.1016/j.gie.2018.12.021 |
| Online Access: | Verlag, Pay-per-use, Volltext: https://doi.org/10.1016/j.gie.2018.12.021 Verlag, Pay-per-use, Volltext: http://www.sciencedirect.com/science/article/pii/S0016510719300021 
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| Author Notes: | Chen Chen, Christian Stock, Michael Hoffmeister, Hermann Brenner |
| Summary: | Background and Aims - Recent guidelines on colorectal cancer (CRC) screening recommend starting screening earlier than before. We performed a simulation study to examine and compare the optimal ages to have once-only screening colonoscopy and repeated colonoscopies. - Methods - A Markov model was set up using data from the German national screening colonoscopy registry to simulate the natural history of the adenoma-carcinoma process. CRC deaths and years of potential life lost (YPLL) for a hypothetical unscreened 50-year-old German population were estimated for a single screening colonoscopy or 2 or 3 screening colonoscopies with 10-year intervals at various ages. - Results - One single screening colonoscopy performed between 50 and 65 years of age was expected to reduce CRC death by 49% to 69% and YPLL by 51% to 68%. An inverted U-shaped association was found between screening age and proportion of CRC deaths or YPLL prevented. The optimal age for once-only colonoscopy that yielded the highest reductions in YPLL was around 54 years for men and 56 years for women. Estimates were approximately 6 to 8 years higher when proportions of CRC deaths prevented were examined. For 2 or 3 screening colonoscopies, the optimal starting age fell to around 50 years or even younger for both genders. - Conclusions - Based on the YPLL estimates, in a high CRC incidence and high life expectancy country like Germany, the optimal age for once-only screening colonoscopy is around 55 years and possibly slightly younger for men than for women. When 2 or more screening colonoscopies are offered with 10-year intervals, screening should start at age 50 at the latest or possibly even younger for both genders. |
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| Item Description: | Gesehen am 15.05.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1097-6779 |
| DOI: | 10.1016/j.gie.2018.12.021 |