Cost‐effectiveness of colorectal cancer screening strategies: A systematic review

Gheysariyeha, Fatemeh; Rahimi, Farimah; Tabesh, Elham; Hemami, Mohsen Rezaei; Adibi, Peyman; Rezayatmand, Reza

doi:10.1111/ecc.13673

Cited by 85 publications

(1 citation statement)

References 34 publications

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“…The development of advanced molecular techniques comes with aid in the detection and treatment of CRC. Currently, proteins, DNA (detection of mutations and methylation markers), RNA (mainly microRNAs), volatile organic compounds, changes, and shifts in gut microbiome composition are the categories of colorectal biomarkers that have been explored 2 .…”

mentioning

confidence: 99%

A commentary on ‘Application and development of noninvasive biomarkers for colorectal cancer screening: a systematic review’

Ren

Miao

2023

International Journal of Surgery

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mentioning

confidence: 99%

A commentary on ‘Application and development of noninvasive biomarkers for colorectal cancer screening: a systematic review’

Ren

Miao

2023

International Journal of Surgery

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Prevalence of Colorectal Neoplasia 10 or More Years After a Negative Screening Colonoscopy in 120 000 Repeated Screening Colonoscopies

Heisser

Kretschmann²,

Hagen³

et al. 2023

JAMA Intern Med

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ImportanceScreening colonoscopy to prevent and early detect colorectal cancer is recommended to be repeated in 10-year intervals, which goes along with high demands of capacities and costs. Evidence of findings at screening colonoscopies conducted 10 or more years after a negative colonoscopy result is sparse, and it remains unclear whether screening colonoscopy intervals could possibly be prolonged.ObjectiveTo assess the prevalence of advanced colorectal neoplasms (ADNs) at least 10 years after a negative screening colonoscopy in a very large cohort of repeated screening colonoscopy participants in Germany.Design, Setting, and ParticipantsThis registry-based cross-sectional study on screening colonoscopy findings reported to the German screening colonoscopy registry during January 2013 to December 2019 included data on screening colonoscopies that were offered to the German general population 55 years or older since 2002; virtually all screening colonoscopies among individuals covered by Statutory Health Insurance (approximately 90% of eligible adults) are reported to the national registry. A total of 120 298 repeat screening colonoscopy participants 65 years or older were identified who had a previous negative screening colonoscopy at least 10 years prior. The findings were compared with all screening colonoscopies conducted at 65 years or older during the same period (1.25 million). The data were analyzed from March to July 2022.Main Outcomes and MeasuresPrevalence of colorectal cancers and ADNs (advanced adenomas and cancers).ResultsOf 120 298 participants, 72 349 (60.1%) were women. Prevalence of ADN was 3.6% and 5.2% among women and men 10 years after a negative screening colonoscopy and gradually increased to 4.9% and 6.6%, respectively, among those who had a negative colonoscopy 14 years or longer prior compared with 7.1% and 11.6% among all screening colonoscopies. Sex-specific and age-specific prevalence of ADNs at repeated colonoscopies conducted 10 or more years after a negative colonoscopy were consistently at least 40% lower among women than among men, lower at younger vs older ages, and much lower than among all screening colonoscopies (standardized prevalence ratios for cancers: 0.22-0.38 among women, 0.15-0.24 among men; standardized prevalence ratios for ADNs: 0.49-0.62 among women, 0.50-0.56 among men).Conclusions and RelevanceThe results of this cross-sectional study suggest that ADN prevalence at screening colonoscopies conducted 10 or more years after a negative screening colonoscopy is low. Extension of the currently recommended 10-year screening intervals may be warranted, especially for female and younger participants without gastrointestinal symptoms.

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Population-Based Prostate Cancer Screening With Magnetic Resonance Imaging or Ultrasonography

et al. 2021

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IMPORTANCE Screening for prostate cancer using prostate-specific antigen (PSA) testing can lead to problems of underdiagnosis and overdiagnosis. Short, noncontrast magnetic resonance imaging (MRI) or transrectal ultrasonography might overcome these limitations. OBJECTIVE To compare the performance of PSA testing, MRI, and ultrasonography as screening tests for prostate cancer. DESIGN, SETTING, AND PARTICIPANTS This prospective, population-based, blinded cohort study was conducted at 7 primary care practices and 2 imaging centers in the United Kingdom. Men 50 to 69 years of age were invited for prostate cancer screening from October 10, 2018, to May 15, 2019. INTERVENTIONS All participants underwent screening with a PSA test, MRI (T2 weighted and diffusion), and ultrasonography (B-mode and shear wave elastography). The tests were independently interpreted without knowledge of other results. Both imaging tests were reported on a validated 5-point scale of suspicion. If any test result was positive, a systematic 12-core biopsy was performed. Additional image fusion-targeted biopsies were performed if the MRI or ultrasonography results were positive. MAIN OUTCOMES AND MEASURES The main outcome was the proportion of men with positive MRI or ultrasonography (defined as a score of 3-5 or 4-5) or PSA test (defined as PSA Ն3 μg/L) results. Key secondary outcomes were the number of clinically significant and clinically insignificant cancers detected if each test was used exclusively. Clinically significant cancer was defined as any Gleason score of 3+4 or higher. RESULTS A total of 2034 men were invited to participate; of 411 who attended screening, 408 consented to receive all screening tests. The proportion with positive MRI results (score, 3-5) was higher than the proportion with positive PSA test results (72 [17.7%; 95% CI, 14.3%-21.8%] vs 40 [9.9%; 95% CI, 7.3%-13.2%]; P < .001). The proportion with positive ultrasonography results (score, 3-5) was also higher than the proportion of those with positive PSA test results (96 [23.7%; 95% CI, 19.8%-28.1%]; P < .001). For an imaging threshold of score 4 to 5, the proportion with positive MRI results was similar to the proportion with positive PSA test results (43 [10.6%; 95% CI, 7.9%-14.0%]; P = .71), as was the proportion with positive ultrasonography results (52 [12.8%; 95% CI, 9.9%-16.5%]; P = .15). The PSA test (Ն3 ng/mL) detected 7 clinically significant cancers, an MRI score of 3 to 5 detected 14 cancers, an MRI score of 4 to 5 detected 11 cancers, an ultrasonography score of 3 to 5 detected 9 cancer, and an ultrasonography score of 4 to 5 detected 4 cancers. Clinically insignificant cancers were diagnosed by PSA testing in 6 cases, by an MRI score of 3 to 5 in 7 cases, an MRI score of 4 to 5 in 5 cases, an ultrasonography score of 3 to 5 in 13 cases, and an ultrasonography score of 4 to 5 in 7 cases. CONCLUSIONS AND RELEVANCE In this cohort study, when screening the general population for prostate cancer, MRI using a score of 4 or 5 to define a positive test result ...

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Cost‐effectiveness of colorectal cancer screening strategies: A systematic review

Cited by 85 publications

References 34 publications

A commentary on ‘Application and development of noninvasive biomarkers for colorectal cancer screening: a systematic review’

A commentary on ‘Application and development of noninvasive biomarkers for colorectal cancer screening: a systematic review’

Prevalence of Colorectal Neoplasia 10 or More Years After a Negative Screening Colonoscopy in 120 000 Repeated Screening Colonoscopies

Population-Based Prostate Cancer Screening With Magnetic Resonance Imaging or Ultrasonography

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Cost‐effectiveness of colorectal cancer screening strategies: A systematic review

Cited by 85 publications

References 34 publications

A commentary on ‘Application and development of noninvasive biomarkers for colorectal cancer screening: a systematic review’

A commentary on ‘Application and development of noninvasive biomarkers for colorectal cancer screening: a systematic review’

Prevalence of Colorectal Neoplasia 10 or More Years After a Negative Screening Colonoscopy in 120 000 Repeated Screening Colonoscopies

Population-Based Prostate Cancer Screening With Magnetic Resonance Imaging or Ultrasonography

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Prevalence of Colorectal Neoplasia 10 or More Years After a Negative Screening Colonoscopy in 120 000 Repeated Screening Colonoscopies