Colorectal cancer deaths attributable to nonuse of screening in the United States.
Colorectal cancer deaths attributable to nonuse of screening in the United States.
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DOI：
10.1016/j.annepidem.2014.11.011
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发表时间：
2015-03
影响因子：
5.6
通讯作者：
Zauber AG
中科院分区：
文献类型：
--
作者：
Meester RG;Doubeni CA;Lansdorp-Vogelaar I;Goede SL;Levin TR;Quinn VP;Ballegooijen Mv;Corley DA;Zauber AG
Screening is a major contributor to colorectal cancer (CRC) mortality reductions in the U.S., but is underutilized. We estimated the fraction of CRC deaths attributable to nonuse of screening to demonstrate the potential benefits from targeted interventions. The established MISCAN-colon microsimulation model was used to estimate the population attributable fraction (PAF) in people aged ≥50 years. The model incorporates long-term patterns and effects of screening by age and type of screening test. PAF for 2010 was estimated using currently available data on screening uptake; PAF was also projected assuming constant future screening rates to incorporate lagged effects from past increases in screening uptake. We also computed PAF using Levin's formula to gauge how this simpler approach differs from the model-based approach. There were an estimated 51,500 CRC deaths in 2010, about 63% (N∼32,200) of which were attributable to non-screening. The PAF decreases slightly to 58% in 2020. Levin's approach yielded a considerably more conservative PAF of 46% (N∼23,600) for 2010. The majority of current U.S. CRC deaths are attributable to non-screening. This underscores the potential benefits of increasing screening uptake in the population. Traditional methods of estimating PAF underestimated screening effects compared with model-based approaches.
