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Individualizing colonoscopy screening by sex and race
Iris Lansdorp-Vogelaar1, Marjolein van Ballegooijen, Ann G Zauber
1Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. i.vogelaar@erasmusmc.nl
Individualized colorectal cancer (CRC) screening offers marginal benefits but may reduce racial disparities. Further research is needed to explore the feasibility and acceptability of personalized CRC screening strategies.
Area of Science:
- Public Health
- Preventive Medicine
- Health Economics
Background:
- Growing discussion on personalizing colorectal cancer (CRC) screening based on sex and race.
- Current uniform guidelines may not be optimal for all demographic groups.
Purpose of the Study:
- To develop individualized colonoscopic screening guidelines by sex and race for average-risk individuals.
- To compare the cost-effectiveness of individualized versus uniform CRC screening strategies.
Main Methods:
- Utilized the MISCAN-Colon microsimulation model for analysis.
- Estimated life expectancy and lifetime CRC screening/treatment costs.
- Compared no screening, uniform 10-yearly, uniform 8-yearly, and individualized screening strategies.
Main Results:
- Uniform 8-yearly and individualized strategies increased life expectancy by 0.0433-0.0435 years per person.
- Cost per life-year gained was $15,565-$15,837 for both strategies.
- Individualized screening initiated 6 years earlier for Black individuals with shorter intervals compared to White individuals.
Conclusions:
- Individualizing CRC screening yielded only marginal improvements in cost and effectiveness at a population level.
- Personalized guidelines show potential for reducing disparities between Black and White populations.
- The acceptability and feasibility of individualized CRC screening guidelines warrant further investigation.
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