Search publications
Title: Modeling the Adenoma and Serrated Pathway to Colorectal Cancer (ASCCA)
Authors: Greuter MJ; Xu XM; Lew JB; Dekker E; Kuipers EJ; Canfell K; Meijer GA; Coupé VMH
Categories: Cancer Type - Bowel & Colorectal Cancer
Cancer Control, Survivorship, and Outcomes Research - Resources and Infrastructure
Year: 2014
Journal Title: Risk Analysis
Volume: 34
Issue: 5
Page number start: 889
Page number end: 910
Citation: Greuter MJ, Xu XM, Lew JB, Dekker E, Kuipers EJ, Canfell K, Meijer GA, Coupe VMH. Modeling the Adenoma and Serrated Pathway to Colorectal Cancer (ASCCA). Risk Anal 2014; 34:889-910
Abstract: Several colorectal cancer (CRC) screening models have been developed describing the progression of adenomas to CRC. Currently, there is increasing evidence that serrated lesions can also develop into CRC. It is not clear whether screening tests have the same test characteristics for serrated lesions as for adenomas, but lower sensitivities have been suggested. Models that ignore this type of colorectal lesions may provide overly optimistic predictions of the screen-induced reduction in CRC incidence. To address this issue, we have developed the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model that includes the adenoma-carcinoma pathway and the serrated pathway to CRC as well as characteristics of colorectal lesions. The model structure and the calibration procedure are described in detail. Calibration resulted in 19 parameter sets for the adenoma-carcinoma pathway and 13 for the serrated pathway that match the age- and sex-specific adenoma and serrated lesion prevalence in the COlonoscopy versus COlonography Screening (COCOS) trial, Dutch CRC incidence and mortality rates, and a number of other intermediate outcomes concerning characteristics of colorectal lesions. As an example, we simulated outcomes for a biennial fecal immunochemical test screening program and a hypothetical one-time colonoscopy screening program. Inclusion of the serrated pathway influenced the predicted effectiveness of screening when serrated lesions are associated with lower screening test sensitivity or when they are not removed. To our knowledge, this is the first model that explicitly includes the serrated pathway and characteristics of colorectal lesions. It is suitable for the evaluation of the (cost)effectiveness of potential screening strategies for CRC.
Division: Cancer Research Division
DOI: 10.1111/risa.12137
Appears in Collections:Research Articles

Files in This Item:
There are no files associated with this item.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.