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Related Experiment Video

Updated: Apr 14, 2026

Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
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Using the Cancer Risk Management Model to evaluate colorectal cancer screening options for Canada.

A J Coldman1, N Phillips1, J Brisson2

  • 1BC Cancer Research Centre, Vancouver, BC.

Current Oncology (Toronto, Ont.)
|April 25, 2015
PubMed
Summary
This summary is machine-generated.

Comparing colorectal cancer (CRC) screening methods, colonoscopy was most effective but resource-intensive. Fecal immunochemical tests (FIT) showed strong effectiveness and cost-efficiency, outperforming fecal occult blood tests (FOBT).

Keywords:
Colorectal cancercostsoutcomesscreening

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Area of Science:

  • Health economics and outcomes research
  • Cancer screening and prevention
  • Population health modeling

Background:

  • Multiple colorectal cancer (CRC) screening methods exist, with proven effectiveness from randomized trials.
  • Population health simulation models offer a robust platform for comparing diverse screening scenarios.
  • Key screening tests include fecal occult blood test (FOBT), fecal immunochemical test (FIT), flexible sigmoidoscopy, and colonoscopy.

Purpose of the Study:

  • To compare the risks, benefits, and costs of various colorectal cancer screening strategies using a simulation model.
  • To evaluate outcomes such as life-years gained, CRC cases and deaths prevented, and health system costs.

Main Methods:

  • A natural history model of CRC was implemented and calibrated within the Cancer Risk Management Model (CRMM).
  • The CRMM-CRC model simulated 23 distinct screening scenarios, running 10 million replicates for each.
  • Model parameters could be user-defined or program-specified to allow for flexible analysis.

Main Results:

  • All simulated colorectal cancer screening strategies reduced CRC incidence and mortality compared to no screening.
  • Colonoscopy was the most effective screening method but demanded significantly more resources.
  • Fecal immunochemical testing (FIT) emerged as a highly effective and cost-efficient strategy, particularly at a 50 ng/mL threshold, outperforming FOBT.

Conclusions:

  • The CRMM-CRC model is a valuable tool for evaluating colorectal cancer control options.
  • While all tested screening strategies improved CRC mortality, parameter uncertainty exists.
  • Incorporating local data into the model is recommended to enhance the accuracy of screening outcome predictions.