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A decision support model for colorectal cancer screening.

Daniel Corrales1, David Ríos Insua2, Marino J González3

  • 1Institute of Mathematical Sciences, ICMAT-CSIC, 28049 Madrid, Spain; Escuela de Doctorado, Universidad Autónoma de Madrid, 28049 Madrid, Spain.

Computers in Biology and Medicine
|July 23, 2025
PubMed
Summary

Personalized colorectal cancer (CRC) screening strategies, using a decision analysis model, offer improved risk assessment beyond age. This approach optimizes screening choices for individuals, enhancing current public health programs.

Keywords:
Colorectal cancerDecision-makingHealth policyMulti-criteria decision analysisScreening

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Area of Science:

  • Decision analysis
  • Public health
  • Medical informatics

Background:

  • Current European colorectal cancer (CRC) screening programs predominantly use age-based, one-size-fits-all strategies.
  • These programs exhibit minor variations across European nations.
  • There is a need for more personalized approaches to CRC screening.

Purpose of the Study:

  • To develop a decision analysis-based framework for personalized colorectal cancer (CRC) screening.
  • To support decisions on screening methods and the necessity of colonoscopy for individuals.
  • To evaluate and potentially redesign existing national CRC screening programs.

Main Methods:

  • An influence diagram model was developed to characterize CRC risk based on various factors.
  • Decision criteria included comfort, costs, complications, and information (assessed via information-theoretic measures).
  • A multi-attribute utility model integrated these criteria, with optimal screening policies determined by maximizing expected utility.

Main Results:

  • The model enables personalized CRC screening recommendations based on individual features beyond age.
  • It provides a tool for assessing current age-based programs and designing new risk-based strategies.
  • The framework suggests transitioning from age-based to personalized, risk-dependent screening strategies.

Conclusions:

  • This research introduces a novel framework for personalized colorectal cancer (CRC) screening.
  • The proposed approach offers improvements over existing age-based screening strategies.
  • The study highlights opportunities for redesigning and optimizing CRC screening programs.