Optimal age for screening colonoscopy

• Verfasst von: Chen, Chen [VerfasserIn]
• Verfasst von: Stock, Christian [VerfasserIn]
• Verfasst von: Hoffmeister, Michael [VerfasserIn]
• Verfasst von: Brenner, Hermann [VerfasserIn]
• Titel: Optimal age for screening colonoscopy
• Titelzusatz: a modeling study
• Verf.angabe: Chen Chen, Christian Stock, Michael Hoffmeister, Hermann Brenner
• E-Jahr: 2019
• Jahr: 9 January 2019
• Umfang: 21 S.
• Teil: volume:89
• Teil: year:2019
• Teil: number:5
• Teil: pages:1017-1025.e12
• Teil: extent:21
• Fussnoten: Gesehen am 15.05.2019
• Titel Quelle: Enthalten in: Gastrointestinal endoscopy
• Ort Quelle: New York, NY : Elsevier, 1971
• Jahr Quelle: 2019
• Band/Heft Quelle: 89(2019), 5, Seite 1017-1025.e12
• ISSN Quelle: 1097-6779
• DOI: doi:10.1016/j.gie.2018.12.021
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1665728140

Abstract

Background and Aims - Recent guidelines on colorectal cancer (CRC) screening recommend starting screening earlier than before. We performed a simulation study to examine and compare the optimal ages to have once-only screening colonoscopy and repeated colonoscopies. - Methods - A Markov model was set up using data from the German national screening colonoscopy registry to simulate the natural history of the adenoma-carcinoma process. CRC deaths and years of potential life lost (YPLL) for a hypothetical unscreened 50-year-old German population were estimated for a single screening colonoscopy or 2 or 3 screening colonoscopies with 10-year intervals at various ages. - Results - One single screening colonoscopy performed between 50 and 65 years of age was expected to reduce CRC death by 49% to 69% and YPLL by 51% to 68%. An inverted U-shaped association was found between screening age and proportion of CRC deaths or YPLL prevented. The optimal age for once-only colonoscopy that yielded the highest reductions in YPLL was around 54 years for men and 56 years for women. Estimates were approximately 6 to 8 years higher when proportions of CRC deaths prevented were examined. For 2 or 3 screening colonoscopies, the optimal starting age fell to around 50 years or even younger for both genders. - Conclusions - Based on the YPLL estimates, in a high CRC incidence and high life expectancy country like Germany, the optimal age for once-only screening colonoscopy is around 55 years and possibly slightly younger for men than for women. When 2 or more screening colonoscopies are offered with 10-year intervals, screening should start at age 50 at the latest or possibly even younger for both genders.