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  1. Article ; Online: Rationale for organized Colorectal cancer screening programs.

    Senore, Carlo / Lansdorp-Vogelaar, Iris / de Jonge, Lucie / Rabeneck, Linda

    Best practice & research. Clinical gastroenterology

    2023  Volume 66, Page(s) 101850

    Abstract: Colorectal cancer (CRC) is a major health problem and it is expected that the number of persons diagnosed with CRC and CRC-related deaths will continue to increase. However, recent years have shown reductions in CRC incidence and mortality particularly ... ...

    Abstract Colorectal cancer (CRC) is a major health problem and it is expected that the number of persons diagnosed with CRC and CRC-related deaths will continue to increase. However, recent years have shown reductions in CRC incidence and mortality particularly among individuals aged 50 years and older which can be attributed to screening, improvements in patients' management, closer adherence to treatment guideline recommendations and a higher utilization of curative surgery, chemotherapy and radiotherapy. The International Agency for Research on Cancer has concluded that there has been sufficient evidence that biennially screening using a stool-test or once-only endoscopy screening reduces CRC-related mortality. In Europe, between 2008 and 2018, nine countries have successfully implemented a population-based organized program and another six are in the roll-out phase. Population-based organized programs show higher screening participation rates and lower lack of compliance to follow-up testing after a positive screen test compared to opportunistic screening. Moreover, organized programs aim to provide high quality screening thereby reducing the risk of the harms of screening, including over-screening, and complications of screening, and poor follow-up of those who test positive. We describe how population-based organized CRC screening programs are preferred, since they reflect a more appropriate utilization of available resources, reduce inequities in access, and can integrate interventions addressing barriers to screening at the individual and health system levels.
    MeSH term(s) Humans ; Middle Aged ; Aged ; Colonoscopy ; Early Detection of Cancer ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/therapy ; Mass Screening ; Occult Blood
    Language English
    Publishing date 2023-07-05
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2048181-0
    ISSN 1532-1916 ; 1521-6918
    ISSN (online) 1532-1916
    ISSN 1521-6918
    DOI 10.1016/j.bpg.2023.101850
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Elucidating the Drivers for the Rising Incidence of Early-Onset Colorectal Cancer: How Ecologic Studies Could Help and What Is Next.

    Ni, Peiyun / Lansdorp-Vogelaar, Iris / Zauber, Ann G / Cao, Yin

    Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

    2022  Volume 32, Issue 2, Page(s) 164–166

    Abstract: The incidence of colorectal cancer diagnosed before age 50, often referred to as early-onset colorectal cancer, has been increasing, whereas the overall colorectal cancer incidence has declined. Elucidating the drivers for the rising burden of early- ... ...

    Abstract The incidence of colorectal cancer diagnosed before age 50, often referred to as early-onset colorectal cancer, has been increasing, whereas the overall colorectal cancer incidence has declined. Elucidating the drivers for the rising burden of early-onset colorectal cancer is a priority in cancer epidemiology and prevention. In this issue of Cancer Epidemiology, Biomarkers & Prevention, Chen and colleagues demonstrated that ecologic studies are a helpful method to reveal emerging risk factors at the population level and concluded that alcohol use might be a potential contributor to the rising incidence of early-onset colorectal cancer. Moving forward, because of the observed birth cohort effect in early-onset colorectal cancer, where younger generations have a steeper increase, hypothesis-driven investigations on emerging risk factors in recent generations, especially during early life, are warranted. Ultimately, the identified risk factors could be integrated with well-established microsimulation models of colorectal cancer, powerful tools that can simultaneously capture population-level secular changes in risk factors, relative risk estimates for each risk factor, and the natural history of colorectal cancer. This would allow us to quantitatively estimate the explained and unexplained portion of the rising incidence of early-onset colorectal cancer by calendar period and birth cohorts, and to help identify priorities in etiologic research, prevention, and early detection. See related article by Chen et al., p. 217.
    MeSH term(s) Humans ; United States ; Middle Aged ; Colorectal Neoplasms/diagnosis ; Incidence ; Early Detection of Cancer/methods ; Risk Factors
    Language English
    Publishing date 2022-10-21
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 1153420-5
    ISSN 1538-7755 ; 1055-9965
    ISSN (online) 1538-7755
    ISSN 1055-9965
    DOI 10.1158/1055-9965.EPI-22-1126
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A digital intake tool to avert outpatient visits in a FIT-based colorectal cancer screening population: study protocol of a multicentre, prospective non-randomized trial - the DIT-trial.

    Marijnissen, Fleur E / de Jonge, Pieter J F / Erler, Nicole S / Ismail, Sohal Y / Lansdorp-Vogelaar, Iris / Spaander, Manon C W

    BMC gastroenterology

    2024  Volume 24, Issue 1, Page(s) 38

    Abstract: Background: Currently all participants of the Dutch colorectal cancer (CRC) screening program with a positive faecal immunochemical test (FIT) are seen at the outpatient clinic to assess their health status, receive information on colonoscopy and CRC ... ...

    Abstract Background: Currently all participants of the Dutch colorectal cancer (CRC) screening program with a positive faecal immunochemical test (FIT) are seen at the outpatient clinic to assess their health status, receive information on colonoscopy and CRC risk, and provide informed consent. However, for many patients this information could probably also safely be exchanged in an online setting, in order to reduce the burden for patients, healthcare system, and environment. In this study we will evaluate if a face-to-face pre-colonoscopy consultation can be replaced by a Digital Intake Tool (DIT) in a CRC screening population.
    Methods: This is a prospective multicentre single-arm, non-randomized study with a non-inferiority design. The DIT will triage a total of 1000 participants and inform them about CRC risk, colonoscopy, sedation, and provide bowel preparation instructions. Participants identified as high-risk (i.e., red-triaged) will be contacted by phone or scheduled for an appointment at the outpatient clinic. The primary outcome measure will be adequate bowel preparation rate, defined as the proportion of participants with a Boston Bowel Preparation (BBPS) score ≥ 6. To compare our primary outcome, we will use colonoscopy data from 1000 FIT positive participants who visited the outpatient clinic for pre-colonoscopy consultation. Secondary outcomes will include participation rate, colonoscopy adherence rate, patient experience in terms of satisfaction and anxiety, knowledge transfer, number of outpatient visits that can be averted by the DIT, and cost-effectiveness of the tool. Ethical approval was obtained from the Medical Ethical Committee of the Erasmus Medical Center (MEC-2021-0098).
    Discussion: This study aims to assess if a face-to-face pre-colonoscopy consultation can be replaced by an eHealth assessment and education tool in a FIT-based CRC screening program. In case favourable results are established, the intervention evaluated in this study could significantly impact CRC screening programs, benefiting both patients and healthcare systems on a (inter)national scale. Additionally, it would enable more personalized care as the DIT can be easily customized and made feasible in other languages, thereby enhancing healthcare accessibility.
    Trial registration: Dutch Trial Register: NL9315 , date of registration: March 8th, 2021.
    MeSH term(s) Humans ; Colonoscopy/methods ; Colorectal Neoplasms/diagnosis ; Early Detection of Cancer/methods ; Mass Screening/methods ; Multicenter Studies as Topic ; Occult Blood ; Outpatients ; Prospective Studies ; Clinical Trials as Topic
    Language English
    Publishing date 2024-01-18
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article
    ZDB-ID 2041351-8
    ISSN 1471-230X ; 1471-230X
    ISSN (online) 1471-230X
    ISSN 1471-230X
    DOI 10.1186/s12876-023-03039-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Reply.

    Omidvari, Amir-Houshang / Lansdorp-Vogelaar, Iris / Rubenstein, Joel H

    Gastroenterology

    2021  Volume 162, Issue 1, Page(s) 351–352

    Language English
    Publishing date 2021-09-28
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2021.09.056
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Colorectal Cancer Screening in the Novel Coronavirus Disease-2019 Era.

    Dekker, Evelien / Chiu, Han-Mo / Lansdorp-Vogelaar, Iris

    Gastroenterology

    2020  Volume 159, Issue 6, Page(s) 1998–2003

    MeSH term(s) COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19/transmission ; COVID-19/virology ; Colonoscopy/standards ; Colonoscopy/statistics & numerical data ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/prevention & control ; Communicable Disease Control/organization & administration ; Communicable Disease Control/standards ; Early Detection of Cancer/standards ; Early Detection of Cancer/statistics & numerical data ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Infectious Disease Transmission, Professional-to-Patient/prevention & control ; Mass Screening/organization & administration ; Mass Screening/standards ; Mass Screening/statistics & numerical data ; Pandemics/prevention & control ; SARS-CoV-2/pathogenicity
    Keywords covid19
    Language English
    Publishing date 2020-09-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2020.09.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Reply.

    Kooyker, Arthur I / Lansdorp-Vogelaar, Iris / Van Leerdam, Monique E

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

    2021  Volume 20, Issue 6, Page(s) 1418–1419

    Language English
    Publishing date 2021-09-15
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2119789-1
    ISSN 1542-7714 ; 1542-3565
    ISSN (online) 1542-7714
    ISSN 1542-3565
    DOI 10.1016/j.cgh.2021.09.012
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  7. Article ; Online: Optimizing screening with faecal immunochemical test for both sexes - Cost-effectiveness analysis from Finland.

    Heinävaara, Sirpa / Gini, Andrea / Sarkeala, Tytti / Anttila, Ahti / de Koning, Harry / Lansdorp-Vogelaar, Iris

    Preventive medicine

    2022  Volume 157, Page(s) 106990

    Abstract: A faecal immunochemical test (FIT) screening pilot was introduced in Finland in 2019 with sex-specific screening strategies. This study aims to model cost-effectiveness of sex-specific strategies for the whole population, and to assess whether the ... ...

    Abstract A faecal immunochemical test (FIT) screening pilot was introduced in Finland in 2019 with sex-specific screening strategies. This study aims to model cost-effectiveness of sex-specific strategies for the whole population, and to assess whether the current strategies are optimal. We developed separate MISCAN-Colon models, including different FIT performances, for the Finnish men and women using the first-year data of the FIT screening pilot. We evaluated 180 FIT strategies varying in FIT cut-off, screening interval, age to start, and age to stop screening, and compared them to no-screening by sex. We used incremental cost-effectiveness ratios (ICERs) to identify the optimal strategy after combining all male and female strategies and restricting the analysis by costs and referral rate to diagnostic colonoscopies. Offering annual FIT screening with a cut-off of 25 μg/g at 50-79 years in men and with a cut-off of 10 μg/g at 55-69 years in women was optimal. This combined strategy prevented 28% of colorectal cancer (CRC) cases and 55% of CRC deaths with acceptable costs (ICER = 9000€/life-years gained). Screening at the current target age of 60-74 years was suboptimal for both sexes. Among strategies with the same target age and interval for both sexes, expected benefits from optimal screening were lower but still reasonable. Our results support a wider age range of screening in men, and a lower cut-off for a positive test in women when restrictions on colonoscopy capacity and costs are in place. National FIT screening program should start at younger age.
    MeSH term(s) Aged ; Colonoscopy ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/prevention & control ; Cost-Benefit Analysis ; Early Detection of Cancer/methods ; Female ; Finland ; Humans ; Male ; Mass Screening/methods ; Middle Aged ; Occult Blood
    Language English
    Publishing date 2022-02-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 184600-0
    ISSN 1096-0260 ; 0091-7435
    ISSN (online) 1096-0260
    ISSN 0091-7435
    DOI 10.1016/j.ypmed.2022.106990
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  8. Article ; Online: Development and validation of colorectal cancer risk prediction tools: A comparison of models.

    Mülder, Duco T / van den Puttelaar, Rosita / Meester, Reinier G S / O'Mahony, James F / Lansdorp-Vogelaar, Iris

    International journal of medical informatics

    2023  Volume 178, Page(s) 105194

    Abstract: Background: Identification of individuals at elevated risk can improve cancer screening programmes by permitting risk-adjusted screening intensities. Previous work introduced a prognostic model using sex, age and two preceding faecal haemoglobin ... ...

    Abstract Background: Identification of individuals at elevated risk can improve cancer screening programmes by permitting risk-adjusted screening intensities. Previous work introduced a prognostic model using sex, age and two preceding faecal haemoglobin concentrations to predict the risk of colorectal cancer (CRC) in the next screening round. Using data of 3 screening rounds, this model attained an area under the receiver-operating-characteristic curve (AUC) of 0.78 for predicting advanced neoplasia (AN). We validated this existing logistic regression (LR) model and attempted to improve it by applying a more flexible machine-learning approach.
    Methods: We trained an existing LR and a newly developed random forest (RF) model using updated data from 219,257 third-round participants of the Dutch CRC screening programme until 2018. For both models, we performed two separate out-of-sample validations using 1,137,599 third-round participants after 2018 and 192,793 fourth-round participants from 2020 onwards. We evaluated the AUC and relative risks of the predicted high-risk groups for the outcomes AN and CRC.
    Results: For third-round participants after 2018, the AUC for predicting AN was 0.77 (95% CI: 0.76-0.77) using LR and 0.77 (95% CI: 0.77-0.77) using RF. For fourth-round participants, the AUCs were 0.73 (95% CI: 0.72-0.74) and 0.73 (95% CI: 0.72-0.74) for the LR and RF models, respectively. For both models, the 5% with the highest predicted risk had a 7-fold risk of AN compared to average, whereas the lowest 80% had a risk below the population average for third-round participants.
    Conclusion: The LR is a valid risk prediction method in stool-based screening programmes. Although predictive performance declined marginally, the LR model still effectively predicted risk in subsequent screening rounds. An RF did not improve CRC risk prediction compared to an LR, probably due to the limited number of available explanatory variables. The LR remains the preferred prediction tool because of its interpretability.
    Language English
    Publishing date 2023-08-16
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 1466296-6
    ISSN 1872-8243 ; 1386-5056
    ISSN (online) 1872-8243
    ISSN 1386-5056
    DOI 10.1016/j.ijmedinf.2023.105194
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  9. Article ; Online: NordICC Trial Results in Line With Expected Colorectal Cancer Mortality Reduction After Colonoscopy: A Modeling Study.

    van den Berg, Danica M N / Nascimento de Lima, Pedro / Knudsen, Amy B / Rutter, Carolyn M / Weinberg, David / Lansdorp-Vogelaar, Iris

    Gastroenterology

    2023  Volume 165, Issue 4, Page(s) 1077–1079.e2

    MeSH term(s) Humans ; Colonoscopy/methods ; Colorectal Neoplasms/diagnosis ; Early Detection of Cancer/methods ; Mass Screening/methods
    Language English
    Publishing date 2023-07-15
    Publishing country United States
    Document type Letter ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2023.06.035
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Emulator-based Bayesian calibration of the CISNET colorectal cancer models.

    Pineda-Antunez, Carlos / Seguin, Claudia / van Duuren, Luuk A / Knudsen, Amy B / Davidi, Barak / de Lima, Pedro Nascimento / Rutter, Carolyn / Kuntz, Karen M / Lansdorp-Vogelaar, Iris / Collier, Nicholson / Ozik, Jonathan / Alarid-Escudero, Fernando

    medRxiv : the preprint server for health sciences

    2024  

    Abstract: Purpose: To calibrate Cancer Intervention and Surveillance Modeling Network (CISNET) 's SimCRC, MISCAN-Colon, and CRC-SPIN simulation models of the natural history colorectal cancer (CRC) with an emulator-based Bayesian algorithm and internally validate ...

    Abstract Purpose: To calibrate Cancer Intervention and Surveillance Modeling Network (CISNET) 's SimCRC, MISCAN-Colon, and CRC-SPIN simulation models of the natural history colorectal cancer (CRC) with an emulator-based Bayesian algorithm and internally validate the model-predicted outcomes to calibration targets.
    Methods: We used Latin hypercube sampling to sample up to 50,000 parameter sets for each CISNET-CRC model and generated the corresponding outputs. We trained multilayer perceptron artificial neural networks (ANN) as emulators using the input and output samples for each CISNET-CRC model. We selected ANN structures with corresponding hyperparameters (i.e., number of hidden layers, nodes, activation functions, epochs, and optimizer) that minimize the predicted mean square error on the validation sample. We implemented the ANN emulators in a probabilistic programming language and calibrated the input parameters with Hamiltonian Monte Carlo-based algorithms to obtain the joint posterior distributions of the CISNET-CRC models' parameters. We internally validated each calibrated emulator by comparing the model-predicted posterior outputs against the calibration targets.
    Results: The optimal ANN for SimCRC had four hidden layers and 360 hidden nodes, MISCAN-Colon had 4 hidden layers and 114 hidden nodes, and CRC-SPIN had one hidden layer and 140 hidden nodes. The total time for training and calibrating the emulators was 7.3, 4.0, and 0.66 hours for SimCRC, MISCAN-Colon, and CRC-SPIN, respectively. The mean of the model-predicted outputs fell within the 95% confidence intervals of the calibration targets in 98 of 110 for SimCRC, 65 of 93 for MISCAN, and 31 of 41 targets for CRC-SPIN.
    Conclusions: Using ANN emulators is a practical solution to reduce the computational burden and complexity for Bayesian calibration of individual-level simulation models used for policy analysis, like the CISNET CRC models. In this work, we present a step-by-step guide to constructing emulators for calibrating three realistic CRC individual-level models using a Bayesian approach.
    Language English
    Publishing date 2024-02-05
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2023.02.27.23286525
    Database MEDical Literature Analysis and Retrieval System OnLINE

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