||1R15CA208881-01A1 Interpret this number
||Louisiana Tech University
||Quantification of Colonic Neoplasia Growth and Impact on Colonoscopy Follow-Up
PROJECT SUMMARY / ABSTRACT
The ability to detect and remove adenomas along the length of the colon during colonoscopy essentially short-
circuits the development of CRC and screening is associated with lower colorectal cancer (CRC) mortality. But
follow-up care is needed to provide further benefit because the CRC preventive effects of polypectomy fade
with time as new or over-looked neoplasia develop and grow. Understanding the effects of follow-up care has
become important because, with the recent recommendation of an average risk screening colonoscopy, there
is a large cohort of patients who are eligible for colonoscopy follow-up care. The effects and risks for
screening colonoscopy have been studied, but the risk dynamics of CRC and the appropriate care following an
initial colonoscopy are not well understood. Therefore, the long-term objective of this research is to quantify
the risk dynamics for colorectal cancer following a colonoscopy and to identify patients who are candidates for
either more or less intensive monitoring. To accomplish this objective, colonic neoplasia growth rates will be
quantified by fitting the rates in a predictive model of colonic neoplasia development to serial colonoscopy
results. In particular, we are interested in quantifying how the colonic neoplasia growth rates vary by sex,
colon location, patient age, and patient-specific colonoscopy results. Quantifying these differences gives the
patient-specific dynamics of colorectal cancer risk. The colonic growth rates will be used in stochastic
simulations of colorectal cancer monitoring protocols to identify the optimal (greatest increase in quality-
adjusted life years), cost-effective follow-up care based on a patient?s risk factors.
Evaluating the Cost-Effective Use of Follow-Up Colonoscopy Based on Screening Findings and Age.
, Heidarnejad F.
, Sherer E.A.
Computational and mathematical methods in medicine, 2019; 2019, p. 2476565.