Amy Knudsen, PhD, Senior Scientist at the MGH Institute for Technology Assessment, led a team of researchers commissioned by the US Preventive Services Task Force (USPSTF) to estimate the benefits, burdens, and harms of colorectal cancer screening. The study, published in the Journal of the American Medical Association in May 2021, helped inform the USPSTF recommendation to lower the starting age for colorectal cancer screening to age 45.
Using simulation modeling, the authors estimated that screening for colorectal cancer with any one of the 162 screening strategies evaluated would result in a substantial increase in life expectancy (171-381 life-years gained per 1000 persons) and substantial reductions in the lifetime numbers of colorectal cancer cases and colorectal cancer deaths (16-74 and 15-32 cases and deaths averted per 1000 persons, respectively) when compared to no screening. Among the strategies highlighted in the 2016 USPSTF colorectal cancer screening recommendation, lowering the age to begin screening from 50 to 45 was estimated to result in 22 to 27 additional life-years gained, 161 to 784 additional colonoscopies, and 0.1 to 2 additional screening complications (numbers are over the lifetimes of 1000 persons screened). The benefits from continuing colorectal cancer screening beyond age 75 were estimated to be small among persons who were adherent with screening prior to that age.
The study was performed by researchers with the Cancer Intervention and Surveillance Modeling Network (CISNET) and was authored by Amy Knudsen, Carolyn Rutter, Elisabeth Peterse, Anna Lietz, Claudia Seguin, Reinier Meester, Leslie Perdue, Jennifer Lin, Rebecca Siegel, Paul Doria-Rose, Eric Feuer, Ann Zauber, Karen Kuntz, and Iris Lansdorp-Vogelaar.
The article is available for free from https://jamanetwork.com/journals/jama/fullarticle/2779986. An interactive version of the model findings is available at https://resources.cisnet.cancer.gov/projects/#crcr/uspstf-2021/ .