An Evidence-Based Microsimulation Model for Colorectal Cancer: Validation and Application
- 1 August 2010
- journal article
- research article
- Published by American Association for Cancer Research (AACR) in Cancer Epidemiology, Biomarkers & Prevention
- Vol. 19 (8), 1992-2002
- https://doi.org/10.1158/1055-9965.epi-09-0954
Abstract
Background: The Colorectal Cancer Simulated Population model for Incidence and Natural history (CRC-SPIN) is a new microsimulation model for the natural history of colorectal cancer that can be used for comparative effectiveness studies of colorectal cancer screening modalities. Methods: CRC-SPIN simulates individual event histories associated with colorectal cancer, based on the adenoma-carcinoma sequence: adenoma initiation and growth, development of preclinical invasive colorectal cancer, development of clinically detectable colorectal cancer, death from colorectal cancer, and death from other causes. We present the CRC-SPIN structure and parameters, data used for model calibration, and model validation. We also provide basic model outputs to further describe CRC-SPIN, including annual transition probabilities between various disease states and dwell times. We conclude with a simple application that predicts the impact of a one-time colonoscopy at age 50 on the incidence of colorectal cancer assuming three different operating characteristics for colonoscopy. Results: CRC-SPIN provides good prediction of both the calibration and the validation data. Using CRC-SPIN, we predict that a one-time colonoscopy greatly reduces colorectal cancer incidence over the subsequent 35 years. Conclusions: CRC-SPIN is a valuable new tool for combining expert opinion with observational and experimental results to predict the comparative effectiveness of alternative colorectal cancer screening modalities. Impact: Microsimulation models such as CRC-SPIN can serve as a bridge between screening and treatment studies and health policy decisions by predicting the comparative effectiveness of different interventions. As such, it is critical to publish model descriptions that provide insight into underlying assumptions along with validation studies showing model performance. Cancer Epidemiol Biomarkers Prev; 19(8); 1992–2002. ©2010 AACR.This publication has 33 references indexed in Scilit:
- Polyp measurement based on CT colonography and colonoscopy: variability and systematic differencesEuropean Radiology, 2009
- Bayesian Calibration of Microsimulation ModelsJournal of the American Statistical Association, 2009
- Annual Report to the Nation on the Status of Cancer, 1975–2005, Featuring Trends in Lung Cancer, Tobacco Use, and Tobacco ControlJNCI Journal of the National Cancer Institute, 2008
- Trends in Colorectal Cancer Testing Among Medicare SubpopulationsAmerican Journal of Preventive Medicine, 2008
- Five-Year Risk of Colorectal Neoplasia after Negative Screening ColonoscopyThe New England Journal of Medicine, 2008
- Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline From the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of RadiologyGastroenterology, 2008
- Cost‐effectiveness of colorectal cancer screening with computed tomography colonographyCancer, 2007
- Polyp Miss Rate Determined by Tandem Colonoscopy: A Systematic ReviewThe American Journal of Gastroenterology, 2006
- Clinical Significance of Small Colorectal PolypsDiseases of the Colon & Rectum, 2004
- Brain growth in mallards, Pekin and Muscovy ducks (Anatidae)Journal of Zoology, 2000