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Predicting the effectiveness of the Finnish population-based colorectal cancer screening programme.
- Source :
-
Journal of medical screening [J Med Screen] 2017 Dec; Vol. 24 (4), pp. 182-188. Date of Electronic Publication: 2017 Jan 13. - Publication Year :
- 2017
-
Abstract
- Objective Because colorectal cancer (CRC) has a long natural history, estimating the effectiveness of CRC screening programmes requires long-term follow-up. As an alternative, we here demonstrate the use of a temporal multi-state natural history model to predict the effectiveness of CRC screening. Methods In the Finnish population-based biennial CRC screening programme using faecal occult blood tests (FOBT), which was conducted in a randomised health services study, we estimated the pre-clinical incidence, the mean sojourn time (MST), and the sensitivity of FOBT using a Markov model to analyse data from 2004 to 2007. These estimates were applied to predict, through simulation, the effects of five rounds of screening on the relative rate of reducing advanced CRC with 6 years of follow-up, and on the reduction in mortality with 10 years of follow-up, in a cohort of 500,000 subjects aged 60 to 69. Results For localised and non-localised CRC, respectively, the MST was 2.06 and 1.36 years and the sensitivity estimates were 65.12% and 73.70%. The predicted relative risk of non-localised CRC and death from CRC in the screened compared with the control population was 0.86 (95% CI: 0.79-0.98) and 0.91 (95% CI: 0.85-1.02), respectively. Conclusion Based on the preliminary results of the Finnish CRC screening programme, our model predicted a 9% reduction in CRC mortality and a 14% reduction in advanced CRC.
- Subjects :
- Aged
Cohort Studies
Colorectal Neoplasms epidemiology
Colorectal Neoplasms prevention & control
Early Detection of Cancer methods
Finland epidemiology
Humans
Incidence
Male
Mass Screening methods
Mass Screening standards
Middle Aged
Occult Blood
Sensitivity and Specificity
Colorectal Neoplasms diagnosis
Early Detection of Cancer standards
Subjects
Details
- Language :
- English
- ISSN :
- 1475-5793
- Volume :
- 24
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of medical screening
- Publication Type :
- Academic Journal
- Accession number :
- 28084889
- Full Text :
- https://doi.org/10.1177/0969141316684524