The impact of stratifying by family history in colorectal cancer screening programs

Simon Lucas Goede, Linda Rabeneck, Iris Lansdorp-Vogelaar, Ann G. Zauber, Lawrence F. Paszat, Jeffrey S Hoch, Jean H.E. Yong, Frank Van Hees, Jill Tinmouth, Marjolein Van Ballegooijen

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

In the province-wide colorectal cancer (CRC) screening program in Ontario, Canada, individuals with a family history of CRC are offered colonoscopy screening and those without are offered guaiac fecal occult blood testing (gFOBT, Hemoccult II). We used microsimulation modeling to estimate the cumulative number of CRC deaths prevented and colonoscopies performed between 2008 and 2038 with this family history-based screening program, compared to a regular gFOBT program. In both programs, we assumed screening uptake increased from 30% (participation level in 2008 before the program was launched) to 60%. We assumed that 11% of the population had a family history, defined as having at least one first-degree relative diagnosed with CRC. The programs offered screening between age 50 and 74 years, every two years for gFOBT, and every ten years for colonoscopy. Compared to opportunistic screening (2008 participation level kept constant at 30%), the gFOBT program cumulatively prevented 6,700 more CRC deaths and required 570,000 additional colonoscopies by 2038. The family history-based screening program increased these numbers to 9,300 and 1,100,000, a 40% and 93% increase, respectively. If biennial gFOBT was replaced with biennial fecal immunochemical test (FIT), annual Hemoccult Sensa or five-yearly sigmoidoscopy screening, both the added benefits and colonoscopies required would decrease. A biennial gFOBT screening program that identifies individuals with a family history of CRC and recommends them to undergo colonoscopy screening would prevent 40% (range in sensitivity analyses: 20-51%) additional deaths while requiring 93% (range: 43-116%) additional colonoscopies, compared to a regular gFOBT screening program. What's new? One of the first population-based screening programs for colorectal cancer (CRC) to offer colonoscopy for individuals with a family history of the disease is Canada's ColonCancerCheck. The present study estimated the long-term effects of the program, to 2038, via microsimulation modeling. Compared with a program based on guaiac fecal occult blood testing (gFOBT) alone, the family history-based program was projected to prevent 40% more deaths. The incorporation of family history-based colonoscopy into CRC screening was estimated to increase demand for the procedure by 93%.

Original languageEnglish (US)
Pages (from-to)1119-1127
Number of pages9
JournalInternational Journal of Cancer
Volume137
Issue number5
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

Fingerprint

Guaiac
Occult Blood
Colonoscopy
Early Detection of Cancer
Colorectal Neoplasms
Canada
Sigmoidoscopy
Ontario
Population

Keywords

  • colorectal cancer
  • computer simulation
  • prevention and control
  • screening

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

Cite this

Goede, S. L., Rabeneck, L., Lansdorp-Vogelaar, I., Zauber, A. G., Paszat, L. F., Hoch, J. S., ... Van Ballegooijen, M. (2015). The impact of stratifying by family history in colorectal cancer screening programs. International Journal of Cancer, 137(5), 1119-1127. https://doi.org/10.1002/ijc.29473

The impact of stratifying by family history in colorectal cancer screening programs. / Goede, Simon Lucas; Rabeneck, Linda; Lansdorp-Vogelaar, Iris; Zauber, Ann G.; Paszat, Lawrence F.; Hoch, Jeffrey S; Yong, Jean H.E.; Van Hees, Frank; Tinmouth, Jill; Van Ballegooijen, Marjolein.

In: International Journal of Cancer, Vol. 137, No. 5, 01.09.2015, p. 1119-1127.

Research output: Contribution to journalReview article

Goede, SL, Rabeneck, L, Lansdorp-Vogelaar, I, Zauber, AG, Paszat, LF, Hoch, JS, Yong, JHE, Van Hees, F, Tinmouth, J & Van Ballegooijen, M 2015, 'The impact of stratifying by family history in colorectal cancer screening programs', International Journal of Cancer, vol. 137, no. 5, pp. 1119-1127. https://doi.org/10.1002/ijc.29473
Goede SL, Rabeneck L, Lansdorp-Vogelaar I, Zauber AG, Paszat LF, Hoch JS et al. The impact of stratifying by family history in colorectal cancer screening programs. International Journal of Cancer. 2015 Sep 1;137(5):1119-1127. https://doi.org/10.1002/ijc.29473
Goede, Simon Lucas ; Rabeneck, Linda ; Lansdorp-Vogelaar, Iris ; Zauber, Ann G. ; Paszat, Lawrence F. ; Hoch, Jeffrey S ; Yong, Jean H.E. ; Van Hees, Frank ; Tinmouth, Jill ; Van Ballegooijen, Marjolein. / The impact of stratifying by family history in colorectal cancer screening programs. In: International Journal of Cancer. 2015 ; Vol. 137, No. 5. pp. 1119-1127.
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