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Chyke Doubeni, S. Weinmann, K. Adams, A. Kamineni, D. Buist, A. Ash, C. Rutter, V. Doria-Rose, D. Corley, R. Greenlee, Jessica Chubak, A. Williams, A. Kroll-Desrosiers, Eric Johnson, Joe Webster, K. Richert-Boe, T. Levin, R. Fletcher, N. Weiss (2013)
Screening Colonoscopy and Risk for Incident Late-Stage Colorectal Cancer Diagnosis in Average-Risk AdultsAnnals of Internal Medicine, 158
R. Yabroff, K. Yabroff, E. Lamont, A. Mariotto, J. Warren, M. Topor, A. Meekins, Martin Brown (2008)
Cost of care for elderly cancer patients in the United States.Journal of the National Cancer Institute, 100 9
M. Dawwas (2014)
Adenoma detection rate and risk of colorectal cancer and death.The New England journal of medicine, 370 26
CA Doubeni, S Weinmann, K Adams (2013)
Screening colonoscopy and risk for incident late-stage colorectal cancer diagnosis in average-risk adults: a nested case-control study., 158
S. Winawer, A. Zauber, M. Ho, M. O'brien, L. Gottlieb, S. Sternberg, J. Waye, M. Schapiro, J. Bond, J. Panish (1993)
Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup.The New England Journal of Medicine, 329
G. Cooper, Fang Xu, Jill Sloan, M. Schluchter, S. Koroukian (2012)
Prevalence and predictors of interval colorectal cancers in Medicare beneficiariesCancer, 118
P Doubilet, CB Begg, MC Weinstein, P Braun, BJ McNeil (1985)
Probabilistic sensitivity analysis using Monte Carlo simulation. A practical approach., 5
(2015)
Colonoscopic withdrawal times and Lifetime Benefits and Costs of Colorectal Cancer Screening Original Investigation Research jama.com (Reprinted
American Cancer Society Colorectal Cancer Advisory Group
M. Kaminski, J. Reguła, E. Kraszewska, M. Pólkowski, U. Wojciechowska, J. Didkowska, M. Zwierko, M. Rupinski, M. Nowacki, E. Butruk (2010)
Quality indicators for colonoscopy and the risk of interval cancer.The New England journal of medicine, 362 19
D. Lieberman, D. Rex, S. Winawer, F. Giardiello, D. Johnson, T. Levin (2012)
Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer.Gastroenterology, 143 3
N. Calonge, D. Petitti, T. Dewitt, A. Dietrich, K. Gregory, Russell Harris, G. Isham, M. LeFevre, R. Leipzig, C. Loveland-Cherry, L. Marion, B. Melnyk, V. Moyer, J. Ockene, G. Sawaya, B. Yawn (2008)
Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement.Annals of internal medicine, 149 9
R. Barclay, J. Vicari, A. Doughty, J. Johanson, R. Greenlaw (2006)
Colonoscopic withdrawal times and adenoma detection during screening colonoscopy.The New England journal of medicine, 355 24
H. Brenner, J. Chang-Claude, L. Jansen, P. Knebel, C. Stock, M. Hoffmeister (2014)
Reduced risk of colorectal cancer up to 10 years after screening, surveillance, or diagnostic colonoscopy.Gastroenterology, 146 3
Gregory Austin, B. Fennimore, D. Ahnen (2013)
Can Colonoscopy Remain Cost-Effective for Colorectal Cancer Screening? The Impact of Practice Patterns and the Will Rogers Phenomenon on CostsThe American Journal of Gastroenterology, 108
P. Maisonneuve, E. Botteri, A. Lowenfels (2008)
Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps.Gastroenterology, 135 2
W. Atkin, R. Edwards, I. Kralj-Hans, K. Wooldrage, Andrew Hart, J. Northover, D. Parkin, J. Wardle, S. Duffy, J. Cuzick (2010)
Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trialThe Lancet, 375
J. Hardcastle, J. Chamberlain, M. Robinson, S. Moss, S. Amar, T. Balfour, P. James, C. Mangham (1989)
Randomised controlled trial of faecal-occult-blood screening for colorectal cancerThe Lancet, 348
D. Leffler, Rakhi Kheraj, S. Garud, N. Neeman, L. Nathanson, C. Kelly, M. Sawhney, B. Landon, R. Doyle, S. Rosenberg, M. Aronson (2010)
The incidence and cost of unexpected hospital use after scheduled outpatient endoscopy.Archives of internal medicine, 170 19
A. Zauber, Knudsen Ab, Rutter Cm, I. Lansdorp-Vogelaar, Savarino Je, M. vanBallegooijen, Kuntz Km (2009)
Cost-Effectiveness of CT Colonography to Screen for Colorectal Cancer
JL Warren, CN Klabunde, AB Mariotto (2009)
Adverse events after outpatient colonoscopy in the Medicare population. Ann Intern Med., 150
Jason Williams, J. Holub, D. Faigel (2012)
Polypectomy rate is a valid quality measure for colonoscopy: results from a national endoscopy database.Gastrointestinal endoscopy, 75 3
D. Robertson, D. Lieberman, S. Winawer, D. Ahnen, J. Baron, A. Schatzkin, A. Cross, A. Zauber, T. Church, P. Lance, E. Greenberg, María Martínez (2013)
Colorectal cancers soon after colonoscopy: a pooled multicohort analysisGut, 63
K. Bibbins-Domingo, D. Grossman, S. Curry, K. Davidson, J. Epling, Francisco García, M. Gillman, D. Harper, A. Kemper, A. Krist, A. Kurth, C. Landefeld, C. Mangione, D. Owens, W. Phillips, M. Phipps, M. Pignone, A. Siu (2016)
Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement.JAMA, 315 23
D. Hewett, D. Rex (2010)
Improving Colonoscopy Quality Through Health-Care Payment ReformThe American Journal of Gastroenterology, 105
Reiko Nishihara, K. Wu, P. Lochhead, T. Morikawa, X. Liao, Z. Qian, K. Inamura, S. Kim, A. Kuchiba, Mai Yamauchi, Yu Imamura, W. Willett, B. Rosner, C. Fuchs, E. Giovannucci, S. Ogino, A. Chan (2013)
Long-term colorectal-cancer incidence and mortality after lower endoscopy.The New England journal of medicine, 369 12
William Farrar, M. Sawhney, D. Nelson, F. Lederle, J. Bond (2006)
Colorectal cancers found after a complete colonoscopy.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 4 10
Christopher Jensen, Chyke Doubeni, V. Quinn, T. Levin, A. Zauber, J. Schottinger, A. Marks, Wei Zhao, Jeffrey-K Lee, Nirupa Ghai, J. Schneider, B. Fireman, C. Quesenberry, D. Corley (2015)
Adjusting for patient demographics has minimal effects on rates of adenoma detection in a large, community-based setting.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 13 4
N. Gatto, H. Frucht, V. Sundararajan, J. Jacobson, V. Grann, A. Neugut (2003)
Risk of perforation after colonoscopy and sigmoidoscopy: a population-based study.Journal of the National Cancer Institute, 95 3
M. Sculpher, A. Basu, K. Kuntz, D. Meltzer (2016)
Reflecting Uncertainty in Cost-Effectiveness Analysis
D. Lieberman, D. Weiss, J. Bond, D. Ahnen, H. Garewal, G. Chejfec (2000)
Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380.The New England journal of medicine, 343 3
D. Rex, D. Ahnen, J. Baron, K. Batts, C. Burke, R. Burt, J. Goldblum, J. Guillem, C. Kahi, M. Kalady, M. O'brien, R. Odze, S. Ogino, S. Parry, D. Snover, E. Torlakovic, P. Wise, Joanne Young, J. Church (2012)
Serrated Lesions of the Colorectum: Review and Recommendations From an Expert PanelThe American Journal of Gastroenterology, 107
P. Doubilet, C. Begg, M. Weinstein, P. Braun, B. McNeil (1985)
Probabilistic Sensitivity Analysis Using Monte Carlo SimulationMedical Decision Making, 5
B. Levin, D. Lieberman, B. McFarland, Kimberly Andrews, D. Brooks, J. Bond, C. Dash, F. Giardiello, S. Glick, D. Johnson, C. Johnson, T. Levin, P. Pickhardt, D. Rex, Robert Smith, A. Thorson, S. Winawer (2008)
Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology.Gastroenterology, 134 5
J. Warren, C. Klabunde, A. Mariotto, A. Meekins, M. Topor, Martin Brown, D. Ransohoff (2009)
Adverse Events After Outpatient Colonoscopy in the Medicare PopulationAnnals of Internal Medicine, 150
SEER stat fact sheets: colon and rectum cancer
SJ Winawer, AG Zauber, MN Ho (1993)
Prevention of colorectal cancer by colonoscopic polypectomy., 329
T. Imperiale, D. Wagner, Ching Lin, G. Larkin, J. Rogge, D. Ransohoff (2000)
Risk of advanced proximal neoplasms in asymptomatic adults according to the distal colorectal findings.The New England journal of medicine, 343 3
Tushar Gohel, C. Burke, Pavan Lankaala, Amareshwar Podugu, R. Kiran, P. Thota, R. Lopez, M. Sanaka (2014)
Polypectomy rate: a surrogate for adenoma detection rate varies by colon segment, gender, and endoscopist.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 12 7
D. Rex, J. Petrini, T. Baron, A. Chak, Jonathan Cohen, S. Deal, B. Hoffman, B. Jacobson, K. Mergener, B. Petersen, M. Safdi, D. Faigel, I. Pike (2006)
Quality Indicators for ColonoscopyAmerican Journal of Gastroenterology, 101
(2014)
of Labor
U. Ladabaum, Zachary Levin, A. Mannalithara, J. Brill, K. Bundorf (2014)
Colorectal Testing Utilization and Payments in a Large Cohort of Commercially Insured US AdultsThe American Journal of Gastroenterology, 109
K. Sheffield, Yimei Han, Y. Kuo, T. Riall, J. Goodwin (2013)
Potentially inappropriate screening colonoscopy in Medicare patients: variation by physician and geographic region.JAMA internal medicine, 173 7
(2012)
United States Multi-Society Task Force on Colorectal Cancer. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society
J. Mandel, T. Church, F. Ederer, J. Bond (1999)
Colorectal cancer mortality: effectiveness of biennial screening for fecal occult blood.Journal of the National Cancer Institute, 91 5
Research Original Investigation Lifetime Benefits and Costs of Colorectal Cancer Screening
N. Baxter, R. Sutradhar, S. Forbes, L. Paszat, R. Saskin, L. Rabeneck (2011)
Analysis of administrative data finds endoscopist quality measures associated with postcolonoscopy colorectal cancer.Gastroenterology, 140 1
A. Adler, K. Wegscheider, D. Lieberman, A. Aminalai, J. Aschenbeck, R. Drossel, M. Mayr, M. Mross, M. Scheel, A. Schröder, K. Gerber, G. Stange, S. Roll, U. Gauger, B. Wiedenmann, L. Altenhofen, T. Rosch (2012)
Factors determining the quality of screening colonoscopy: a prospective study on adenoma detection rates, from 12 134 examinations (Berlin colonoscopy project 3, BECOP-3)Gut, 62
J. Rijn, J. Reitsma, J. Stoker, P. Bossuyt, S. Deventer, E. Dekker (2006)
Polyp Miss Rate Determined by Tandem Colonoscopy: A Systematic ReviewThe American Journal of Gastroenterology, 101
M. Gold (2016)
Cost-effectiveness in health and medicine
ImportanceColonoscopy is the most commonly used colorectal cancer screening test in the United States. Its quality, as measured by adenoma detection rates (ADRs), varies widely among physicians, with unknown consequences for the cost and benefits of screening programs. ObjectiveTo estimate the lifetime benefits, complications, and costs of an initial colonoscopy screening program at different levels of adenoma detection. Design, Setting, and ParticipantsMicrosimulation modeling with data from a community-based health care system on ADR variation and cancer risk among 57 588 patients examined by 136 physicians from 1998 through 2010. ExposuresUsing modeling, no screening was compared with screening initiation with colonoscopy according to ADR quintiles (averages 15.3%, quintile 1; 21.3%, quintile 2; 25.6%, quintile 3; 30.9%, quintile 4; and 38.7%, quintile 5) at ages 50, 60, and 70 years with appropriate surveillance of patients with adenoma. Main Outcomes and MeasuresEstimated lifetime colorectal cancer incidence and mortality, number of colonoscopies, complications, and costs per 1000 patients, all discounted at 3% per year and including 95% confidence intervals from multiway probabilistic sensitivity analysis. ResultsIn simulation modeling, among unscreened patients the lifetime risk of colorectal cancer incidence was 34.2 per 1000 (95% CI, 25.9-43.6) and risk of mortality was 13.4 per 1000 (95% CI, 10.0-17.6). Among screened patients, simulated lifetime incidence decreased with lower to higher ADRs (26.6; 95% CI, 20.0-34.3 for quintile 1 vs 12.5; 95% CI, 9.3-16.5 for quintile 5) as did mortality (5.7; 95% CI, 4.2-7.7 for quintile 1 vs 2.3; 95% CI, 1.7-3.1 for quintile 5). Compared with quintile 1, simulated lifetime incidence was on average 11.4% (95% CI, 10.3%-11.9%) lower for every 5 percentage-point increase of ADRs and for mortality, 12.8% (95% CI, 11.1%-13.7%) lower. Complications increased from 6.0 (95% CI, 4.0-8.5) of 2777 colonoscopies (95% CI, 2626-2943) in quintile 1 to 8.9 (95% CI, 6.1-12.0) complications of 3376 (95% CI, 3081-3681) colonoscopies in quintile 5. Estimated net screening costs were lower from quintile 1 (US $2.1 million, 95% CI, $1.8-$2.4 million) to quintile 5 (US $1.8 million, 95% CI, $1.3-$2.3 million) due to averted cancer treatment costs. Results were stable across sensitivity analyses. Conclusions and RelevanceIn this microsimulation modeling study, higher adenoma detection rates in screening colonoscopy were associated with lower lifetime risks of colorectal cancer and colorectal cancer mortality without being associated with higher overall costs. Future research is needed to assess whether increasing adenoma detection would be associated with improved patient outcomes.
JAMA – American Medical Association
Published: Jun 16, 2015
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