Grant Number:	5U01CA097427-04 Interpret this number
Primary Investigator:	Rutter, Carolyn
Organization:	Group Health Cooperative
Project Title:	Colorectal Cancer Screening:evaluating Trends & Outcomes
Fiscal Year:	2005

DESCRIPTION (provided by applicant)The proposed research develops microsimulation models to examine the effect of screening as practiced on observed trends in colorectal cancer (CRC) incidence and mortality in a defined population of over 500,000 members of Group Health Cooperative (GHC), a large HMO in western Washington. Extensive information about this population is available from automated clinical data systems that capture multiple health care events, including dates and results of laboratory tests (FOBT) and endoscopy procedures, pharmacy utilization, outpatient physician visits and hospitalizations. An established link between GHC and the westem Washington SEER will be used to identify CRC cases in this defined population and a population-based registry of GI pathology will be used to identify non-malignant outcomes (e.g. advanced adenomas) among GHC members. The proposed research will address 3 primary aims: Aim 1: Develop a microsimulation model for colorectal cancer that describes natural history, screening, diagnosis, and mortality: The model we propose takes distributional functions as inputs for unknown parameters, rather than fixed values. The proposed model has at least four key advantages over previous strategies: 1) The model incorporates uncertainty in model inputs; 2) It allows incorporation of correlation between model parameters through their distributional forms; 3) Its use of distributions as inputs essentially automates sensitivity analyses and offers an important advantage over univariate sensitivity analysis; and 4) The model produces distributional estimates for outputs, quantifying their uncertainty. Aim 2: Model the effect of screening and polypectomy on the trends in CRC incidence and mortality within the Group Health Population aged 50 and older. Our model will use data describing dissemination of screening within this population, allowing us to examine the relationship between screening at GHC and trends in rates. Aim 3: Model the combined effect of HRT, screening and polypectomy on trends in CRC incidence within the female Group Health Population aged 50 and older. HRT has been shown to reduce the incidence and perhaps improve mortality from colorectal cancer. Our third aim will allow us to explore mechanisms for this reduction in risk, such as changes in the risks for adenomatous polyps, decreases in their transition to preclinical cancer, and lengthening of sojourn time.




Suspected Extracolonic Neoplasms Detected On Ct Colonography: Literature Review And Possible Outcomes
Authors: Wernli K.J. , Rutter C.M. , Dachman A.H. , Zafar H.M. .
Source: Academic Radiology, 2013 Jun; 20(6), p. 667-74.
PMID: 23465379
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Estimated Mean Sojourn Time Associated With Hemoccult Sensa For Detection Of Proximal And Distal Colorectal Cancer
Authors: Zheng W. , Rutter C.M. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2012 Oct; 21(10), p. 1722-30.
PMID: 22911331
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Adverse events after screening and follow-up colonoscopy.
Authors: Rutter C.M. , Johnson E. , Miglioretti D.L. , Mandelson M.T. , Inadomi J. , Buist D.S. .
Source: Cancer Causes & Control : Ccc, 2012 Feb; 23(2), p. 289-96.
PMID: 22105578
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Comparative economic evaluation of data from the ACRIN National CT Colonography Trial with three cancer intervention and surveillance modeling network microsimulations.
Authors: Vanness D.J. , Knudsen A.B. , Lansdorp-Vogelaar I. , Rutter C.M. , Gareen I.F. , Herman B.A. , Kuntz K.M. , Zauber A.G. , van Ballegooijen M. , Feuer E.J. , et al. .
Source: Radiology, 2011 Nov; 261(2), p. 487-98.
PMID: 21813740
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Computer Disease Simulation Models: Integrating Evidence For Health Policy
Authors: Rutter,C.M. , Knudsen,A.B. , Pandharipande,P.V. .
Source: Academic Radiology, 2011 Sep; 18(9), p. 1077-86.
PMID: 21435924
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A systematic comparison of microsimulation models of colorectal cancer: the role of assumptions about adenoma progression.
Authors: Kuntz K.M. , Lansdorp-Vogelaar I. , Rutter C.M. , Knudsen A.B. , van Ballegooijen M. , Savarino J.E. , Feuer E.J. , Zauber A.G. .
Source: Medical Decision Making : An International Journal Of The Society For Medical Decision Making, 2011 Jul-Aug; 31(4), p. 530-9.
PMID: 21673186
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Clarifying differences in natural history between models of screening: the case of colorectal cancer.
Authors: van Ballegooijen M. , Rutter C.M. , Knudsen A.B. , Zauber A.G. , Savarino J.E. , Lansdorp-Vogelaar I. , Boer R. , Feuer E.J. , Habbema J.D. , Kuntz K.M. .
Source: Medical Decision Making : An International Journal Of The Society For Medical Decision Making, 2011 Jul-Aug; 31(4), p. 540-9.
PMID: 21673187
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Radiation-related cancer risks from CT colonography screening: a risk-benefit analysis.
Authors: Berrington de González A. , Kim K.P. , Knudsen A.B. , Lansdorp-Vogelaar I. , Rutter C.M. , Smith-Bindman R. , Yee J. , Kuntz K.M. , van Ballegooijen M. , Zauber A.G. , et al. .
Source: Ajr. American Journal Of Roentgenology, 2011 Apr; 196(4), p. 816-23.
PMID: 21427330
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Dynamic microsimulation models for health outcomes: a review.
Authors: Rutter C.M. , Zaslavsky A.M. , Feuer E.J. .
Source: Medical Decision Making : An International Journal Of The Society For Medical Decision Making, 2011 Jan-Feb; 31(1), p. 10-8.
PMID: 20484091
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Evaluating Risk Factor Assumptions: A Simulation-based Approach
Authors: Rutter,C.M. , Miglioretti,D.L. , Savarino,J.E. .
Source: Bmc Medical Informatics And Decision Making, 2011; 11, p. 55.
PMID: 21899767
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Cost-effectiveness of computed tomographic colonography screening for colorectal cancer in the medicare population.
Authors: Knudsen A.B. , Lansdorp-Vogelaar I. , Rutter C.M. , Savarino J.E. , van Ballegooijen M. , Kuntz K.M. , Zauber A.G. .
Source: Journal Of The National Cancer Institute, 2010-08-18 00:00:00.0; 102(16), p. 1238-52.
EPub date: 2010-08-18 00:00:00.0.
PMID: 20664028
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An evidence-based microsimulation model for colorectal cancer: validation and application.
Authors: Rutter C.M. , Savarino J.E. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2010 Aug; 19(8), p. 1992-2002.
PMID: 20647403
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Bayesian Calibration Of Microsimulation Models
Authors: Rutter C.M. , Miglioretti D.L. , Savarino J.E. .
Source: Journal Of The American Statistical Association, 2009-12-01 00:00:00.0; 104(488), p. 1338-1350.
PMID: 20076767
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Looking Back At Prospective Studies
Authors: Rutter,C.M. .
Source: Academic Radiology, 2008 Nov; 15(11), p. 1463-6.
PMID: 18995197
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Improvement in the diagnostic evaluation of a positive fecal occult blood test in an integrated health care organization.
Authors: Miglioretti D.L. , Rutter C.M. , Bradford S.C. , Zauber A.G. , Kessler L.G. , Feuer E.J. , Grossman D.C. .
Source: Medical Care, 2008 Sep; 46(9 Suppl 1), p. S91-6.
PMID: 18725839
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A hierarchical non-homogenous Poisson model for meta-analysis of adenoma counts.
Authors: Rutter C.M. , Yu O. , Miglioretti D.L. .
Source: Statistics In Medicine, 2007-01-15 00:00:00.0; 26(1), p. 98-109.
PMID: 16372387
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Transcriptional Targeting Of Adenovirally Delivered Tumor Necrosis Factor Alpha By Temozolomide In Experimental Glioblastoma
Authors: Yamini,B. , Yu,X. , Gillespie,G.Y. , Kufe,D.W. , Weichselbaum,R.R. .
Source: Cancer Research, 2004-09-15 00:00:00.0; 64(18), p. 6381-4.
PMID: 15374943
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