Evidence map›Paper›PMID 38724254›Full record

ArticleBMJ open gastroenterology2024

Population-level impact of the BMJ Rapid Recommendation for colorectal cancer screening: a microsimulation analysis.

Luuk A van Duuren, Jean-Luc Bulliard, Ella Mohr, Rosita van den Puttelaar, Ekaterina Plys, Karen Brändle, Douglas A Corley, Florian Froehlich, Kevin Selby, Iris Lansdorp-Vogelaar

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In one paragraph

Article in BMJ open gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Luuk A van DuurenUnisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland l.vanduuren@erasmusmc.nl.ORCID http://orcid.org/0000-0002-6286-8062
Jean-Luc BulliardUnisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.ORCID http://orcid.org/0000-0001-9750-2709
Ella MohrUnisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.
Rosita van den PuttelaarDepartment of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0003-2216-6557
Ekaterina PlysUnisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.ORCID http://orcid.org/0000-0002-0449-5296
Karen BrändleUnisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.ORCID http://orcid.org/0009-0007-9175-9635
Douglas A CorleyDivision of Research, Kaiser Permanente Northern California, Oakland, California, USA.ORCID http://orcid.org/0000-0001-6132-5165
Florian FroehlichDepartment of Gastroenterology, University of Basel, Basel, Switzerland.ORCID http://orcid.org/0009-0001-3109-0198
Kevin SelbyUnisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.ORCID http://orcid.org/0000-0002-9096-0720
Iris Lansdorp-VogelaarDepartment of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0002-9438-2753

Funding

Comparative Modeling of Effective Policies for Colorectal Cancer ControlU01CA253913 · NCI · SLOAN-KETTERING INST CAN RESEARCH · PI RUTTER, CAROLYN M, ZAUBER, ANN GRAHAM · 2020 to 2025
$6.5M
NCI NIH HHS U01 CA253913
6 · The paper itself

Abstract

objectiveIn 2019, a BMJ Rapid Recommendation advised against colorectal cancer (CRC) screening for adults with a predicted 15-year CRC risk below 3%. Using Switzerland as a case study, we estimated the population-level impact of this recommendation.

designWe predicted the CRC risk of all respondents to the population-based Swiss Health Survey. We derived the distribution of risk-based screening start age, assuming predicted risk was calculated every 5 years between ages 25 and 70 and screening started when this risk exceeded 3%. Next, the MISCAN-Colon microsimulation model evaluated biennial faecal immunochemical test (FIT) screening with this risk-based start age. As a comparison, we simulated screening initiation based on age and sex.

resultsStarting screening only when predicted risk exceeded 3% meant 82% of women and 90% of men would not start screening before age 65 and 60, respectively. This would require 43%-57% fewer tests, result in 8%-16% fewer CRC deaths prevented and yield 19%-33% fewer lifeyears gained compared with screening from age 50. Screening women from age 65 and men from age 60 had a similar impact as screening only when predicted risk exceeded 3%.

conclusionWith the recommended risk prediction tool, the population impact of the BMJ Rapid Recommendation would be similar to screening initiation based on age and sex only. It would delay screening initiation by 10-15 years. Although halving the screening burdens, screening benefits would be reduced substantially compared with screening initiation at age 50. This suggests that the 3% risk threshold to start CRC screening might be too high.

Indexed as

Colorectal NeoplasmsEarly Detection of CancerOccult BloodAdultAgedAge FactorsComputer SimulationFemaleHumansMaleMass ScreeningMiddle AgedPractice Guidelines as TopicRisk AssessmentSwitzerlandCANCER PREVENTIONCOLORECTAL CANCER SCREENINGDECISION ANALYSISSCREENING

Identifiers

PMID38724254
PMCPMC11085988

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.