Evaluating key characteristics of ideal colorectal cancer screening modalities: the microsimulation approach

Background and AimsScreening for colorectal cancer (CRC) can effectively reduce CRC incidence mortality. Besides colonoscopy, tests the detection of biomarkers in stool, blood, or serum, including fecal immunochemical test (FIT), ColoGuard, Epi proColon, PolypDx, have recently been advanced. We aimed to identify characteristics theoretic, highly efficient screening calculated effectiveness cost available tests.MethodsUsing microsimulation-based colon modeling open-source tool (CMOST), we simulated 142,501 theoretic with variable assumptions adenoma carcinoma sensitivity, specificity, frequency, adherence, identified outperforming colonoscopy. For tests, 10 replicates a virtual population 2 million individuals, using epidemiologic costs United States.ResultsHighly were characterized by high sensitivity advanced patient adherence. All effective at 100% adherence expected real-world rates. below threshold 100,000 U.S. dollars per life year gained. With perfect FIT was most cost-efficient intervention, whereas proColon In our analysis, had strongest impact on screening.ConclusionsOur microsimulation study confirmed cost-effectiveness colonoscopy urine-, blood-, stool-based tests. Better results superior prevention whole population. Screening Using States. Highly screening. Our