Impact of the Sessile Serrated Polyp Pathway on Predicted Colorectal Cancer Outcomes
نویسندگان
چکیده
Background and AimsApproximately 20%–30% of colorectal cancers (CRCs) arise from the serrated polyp pathway. CRC screening options have differential sensitivity to detect sessile polyps (SSPs). We used Colorectal Cancer Adenoma Incidence Mortality Microsimulation Model (CRC-AIM) assess how detection SSPs impacts predicted life years gained (LYG), incidence, mortality with multitarget stool DNA (mt-sDNA) or fecal immunochemical test (FIT) screening.MethodsA simulated cohort average-risk US individuals underwent triennial mt-sDNA annual FIT between ages 45–75 years. SSP-attributed CRCs were modeled at 0% (base case), 14.3%, 20%, 30%, in combination 4 adherence & attendance scenarios: S1: 100% stool-screening adherence/100% follow-up colonoscopy after a positive test; S2: reported (mt-sDNA = 71%; 43%)/100% attendance; S3: adherence/reported 72%; 47%); S4: adherence/72% attendance. Outcomes per 1000 individuals. Sensitivity analyses ranges attendance.ResultsAt S1, S2, S3, S4, LYG base case (0% CRC) was 346.7, 279.3, 126.6, 196.1, respectively, 324.6, 311.8, 215.8, respectively. Among adherence/attendance scenarios, modeling decreased by 4.9–20.9 2.0–5.1 mt-sDNA. At S3 30% SSP-attributable CRCs, had 95.1 more LYG, 21.5% greater incidence reduction, 22.2% reduction than FIT.ConclusionIncorporating real-world into CRC-AIM yielded practice-relevant estimates outcomes should be applied future studies afford appropriate assessment comparative effectiveness guideline-endorsed options. Approximately screening. A FIT. Incorporating
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ژورنال
عنوان ژورنال: Gastro Hep advances
سال: 2022
ISSN: ['2772-5723']
DOI: https://doi.org/10.1016/j.gastha.2021.10.007