Grant Number:	5U01CA097426-08 Interpret this number
Primary Investigator:	Zauber, Ann
Organization:	Sloan-Kettering Inst Can Research
Project Title:	Modeling Effective Health Policies for Colorectal Cancer
Fiscal Year:	2009

DESCRIPTION (provided by applicant): Despite recent declines in both incidence and mortality, colorectal cancer (CRC) is the fourth most commonly diagnosed cancer and the second most common cause of cancer deaths in the United States. The present project aims to provide guidance on how to further reduce the burden of this disease, considering interventions based on primary prevention, screening, and treatment improvement. To this end, a wide range of issues is addressed in order to provide an overview of relative effects of alternative intervention policies. This study is a collaboration between Memorial Sloan-Kettering Cancer Center and Erasmus University (Erasmus MC) in Rotterdam. We use a population based microsimulation model (MISCAN-Colon) to assess the effect of individual interventions and combinations on the burden of CRC. MISCAN was originally developed by Erasmus MC to assess screening interventions and has been extended in our current project to incorporate changes in risk factors, chemoprevention and treatment efficacy. This model simulates the full dynamic US population which makes it particularly suitable for assessment of effects of interventions on a population level, including effects on CRC incidence and mortality, and also on quality of life, demands for medical capacity and economic burden over time. In order to make reliable projections for the future, it is necessary to understand to what extent the decline in CRC incidence and mortality is attributable to changes in exposures to "lifestyle" factors, changes in use of screening, changes in treatment, or combinations of these factors. Therefore, the specific aims are to use the MISCAN microsimulation model to 1.) Estimate the absolute and relative contribution of changing lifestyle factors, screening, and improved therapy on the observed trends in CRC incidence and mortality in the United States 1975-2002; and then to explore future scenarios to 2.) Evaluate the potential impact of current and newly developing technologies on lifestyle interventions, chemoprevention, screening, and treatment improvement on future trends in CRC incidence and mortality in the US and 3.) Translate the impact of implementation of interventions found to be effective in reducing incidence and mortality under Aim 2, into the burden of colorectal cancer also with respect to life years gained, quality of life, required medical capacity and economic burden. Aims 2 and 3 will also consider targeted intervention for individuals with increased risk due to familial predisposition. The results from these analyses can be used to inform decisions of directing medical and public health resources to the most effective interventions in the appropriate risk groups. We will collaborate with NCI and other CISNET investigators in conducting this work.




Cost-effectiveness of High-performance Biomarker Tests vs Fecal Immunochemical Test for Non-Invasive Colorectal Cancer Screening.
Authors: Lansdorp-Vogelaar I. , Goede S.L. , Bosch L.J.W. , Melotte V. , Carvalho B. , van Engeland M. , Meijer G.A. , de Koning H.J. , van Ballegooijen M. .
Source: Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association, 2017-07-18 00:00:00.0; , .
EPub date: 2017-07-18 00:00:00.0.
PMID: 28733262
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Harms, benefits and costs of fecal immunochemical testing versus guaiac fecal occult blood testing for colorectal cancer screening.
Authors: Goede S.L. , Rabeneck L. , van Ballegooijen M. , Zauber A.G. , Paszat L.F. , Hoch J.S. , Yong J.H. , Kroep S. , Tinmouth J. , Lansdorp-Vogelaar I. .
Source: Plos One, 2017; 12(3), p. e0172864.
EPub date: 2017-03-15 00:00:00.0.
PMID: 28296927
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The impact of stratifying by family history in colorectal cancer screening programs.
Authors: Goede S.L. , Rabeneck L. , Lansdorp-Vogelaar I. , Zauber A.G. , Paszat L.F. , Hoch J.S. , Yong J.H. , van Hees F. , Tinmouth J. , van Ballegooijen M. .
Source: International Journal Of Cancer, 2015-09-01 00:00:00.0; 137(5), p. 1119-27.
EPub date: 2015-09-01 00:00:00.0.
PMID: 25663135
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Cost-Savings to Medicare From Pre-Medicare Colorectal Cancer Screening.
Authors: Goede S.L. , Kuntz K.M. , van Ballegooijen M. , Knudsen A.B. , Lansdorp-Vogelaar I. , Tangka F.K. , Howard D.H. , Chin J. , Zauber A.G. , Seeff L.C. .
Source: Medical Care, 2015 Jul; 53(7), p. 630-8.
PMID: 26067885
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The impact of screening on colorectal cancer mortality and incidence: has it really made a difference?
Authors: Zauber A.G. .
Source: Digestive Diseases And Sciences, 2015 Mar; 60(3), p. 681-91.
PMID: 25740556
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Smarter screening for cancer: possibilities and challenges of personalization.
Authors: Saini S.D. , van Hees F. , Vijan S. .
Source: Jama, 2014-12-03 00:00:00.0; 312(21), p. 2211-2.
PMID: 25461993
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Personalizing age of cancer screening cessation based on comorbid conditions: model estimates of harms and benefits.
Authors: Lansdorp-Vogelaar I. , Gulati R. , Mariotto A.B. , Schechter C.B. , de Carvalho T.M. , Knudsen A.B. , van Ravesteyn N.T. , Heijnsdijk E.A. , Pabiniak C. , van Ballegooijen M. , et al. .
Source: Annals Of Internal Medicine, 2014-07-15 00:00:00.0; 161(2), p. 104-12.
PMID: 25023249
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Utilization of surveillance after polypectomy in the medicare population--a cohort study.
Authors: Lansdorp-Vogelaar I. , Fedewa S. , Lin C.C. , Virgo K.S. , Jemal A. .
Source: Plos One, 2014; 9(11), p. e110937.
PMID: 25393312
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Multicohort models in cost-effectiveness analysis: why aggregating estimates over multiple cohorts can hide useful information.
Authors: O'Mahony J.F. , van Rosmalen J. , Zauber A.G. , van Ballegooijen M. .
Source: Medical Decision Making : An International Journal Of The Society For Medical Decision Making, 2013 Apr; 33(3), p. 407-14.
PMID: 22927697
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Contribution of screening and survival differences to racial disparities in colorectal cancer rates.
Authors: Lansdorp-Vogelaar I. , Kuntz K.M. , Knudsen A.B. , van Ballegooijen M. , Zauber A.G. , Jemal A. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2012 May; 21(5), p. 728-36.
PMID: 22514249
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Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths.
Authors: Zauber A.G. , Winawer S.J. , O'Brien M.J. , Lansdorp-Vogelaar I. , van Ballegooijen M. , Hankey B.F. , Shi W. , Bond J.H. , Schapiro M. , Panish J.F. , et al. .
Source: The New England Journal Of Medicine, 2012-02-23 00:00:00.0; 366(8), p. 687-96.
PMID: 22356322
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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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How much colonoscopy screening should be recommended to individuals with various degrees of family history of colorectal cancer?
Authors: Wilschut J.A. , Steyerberg E.W. , van Leerdam M.E. , Lansdorp-Vogelaar I. , Habbema J.D. , van Ballegooijen M. .
Source: Cancer, 2011-09-15 00:00:00.0; 117(18), p. 4166-74.
EPub date: 2011-09-15 00:00:00.0.
PMID: 21387272
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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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Cost-effectiveness of colorectal cancer screening.
Authors: Lansdorp-Vogelaar I. , Knudsen A.B. , Brenner H. .
Source: Epidemiologic Reviews, 2011; 33, p. 88-100.
PMID: 21633092
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Cost-effectiveness of colonoscopy.
Authors: Zauber A.G. .
Source: Gastrointestinal Endoscopy Clinics Of North America, 2010 Oct; 20(4), p. 751-70.
PMID: 20889076
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Stool DNA testing to screen for colorectal cancer in the Medicare population: a cost-effectiveness analysis.
Authors: Lansdorp-Vogelaar I. , Kuntz K.M. , Knudsen A.B. , Wilschut J.A. , Zauber A.G. , van Ballegooijen M. .
Source: Annals Of Internal Medicine, 2010-09-21 00:00:00.0; 153(6), p. 368-77.
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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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Simulation of colorectal cancer screening: what we do and do not know and does it matter.
Authors: van Ballegooijen M. , Boer R. , Zauber A.G. .
Source: Best Practice & Research. Clinical Gastroenterology, 2010 Aug; 24(4), p. 427-37.
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Cost-effectiveness of colorectal cancer screening - an overview.
Authors: Lansdorp-Vogelaar I. , Knudsen A.B. , Brenner H. .
Source: Best Practice & Research. Clinical Gastroenterology, 2010 Aug; 24(4), p. 439-49.
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Effect of rising chemotherapy costs on the cost savings of colorectal cancer screening.
Authors: Lansdorp-Vogelaar I. , van Ballegooijen M. , Zauber A.G. , Habbema J.D. , Kuipers E.J. .
Source: Journal Of The National Cancer Institute, 2009-10-21 00:00:00.0; 101(20), p. 1412-22.
EPub date: 2009-10-21 00:00:00.0.
PMID: 19779203
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Individualizing colonoscopy screening by sex and race.
Authors: Lansdorp-Vogelaar I. , van Ballegooijen M. , Zauber A.G. , Boer R. , Wilschut J. , Winawer S.J. , Habbema J.D. .
Source: Gastrointestinal Endoscopy, 2009 Jul; 70(1), p. 96-108, 108.e1-24.
PMID: 19467539
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A novel hypothesis on the sensitivity of the fecal occult blood test: Results of a joint analysis of 3 randomized controlled trials.
Authors: Lansdorp-Vogelaar I. , van Ballegooijen M. , Boer R. , Zauber A. , Habbema J.D. .
Source: Cancer, 2009-06-01 00:00:00.0; 115(11), p. 2410-9.
PMID: 19288570
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At what costs will screening with CT colonography be competitive? A cost-effectiveness approach.
Authors: Lansdorp-Vogelaar I. , van Ballegooijen M. , Zauber A.G. , Boer R. , Wilschut J. , Habbema J.D. .
Source: International Journal Of Cancer, 2009-03-01 00:00:00.0; 124(5), p. 1161-8.
PMID: 19048626
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Evaluating test strategies for colorectal cancer screening: a decision analysis for the U.S. Preventive Services Task Force.
Authors: Zauber A.G. , Lansdorp-Vogelaar I. , Knudsen A.B. , Wilschut J. , van Ballegooijen M. , Kuntz K.M. .
Source: Annals Of Internal Medicine, 2008-11-04 00:00:00.0; 149(9), p. 659-69.
EPub date: 2008-11-04 00:00:00.0.
PMID: 18838717
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Implications of new colorectal cancer screening technologies for primary care practice.
Authors: Zauber A.G. , Levin T.R. , Jaffe C.C. , Galen B.A. , Ransohoff D.F. , Brown M.L. .
Source: Medical Care, 2008 Sep; 46(9 Suppl 1), p. S138-46.
PMID: 18725826
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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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