Knudsen Lab

PI: Amy B. Knudsen, PhD

Colorectal cancer is the second leading cause of cancer death in the United States. Randomized trials have shown that routine screening for colorectal cancer can reduce both the incidence of and the mortality from the disease. However, due to practical limitations, randomized trials cannot be performed to address all questions about colorectal cancer screening. Accordingly, we have developed a microsimulation model – the Simulation Model of Colorectal Cancer (SimCRC) – that can be used to estimate outcomes under different screening scenarios.

SimCRC is one of three models that comprise the National Cancer Institute-funded Cancer Intervention and Surveillance Modeling Network (CISNET) consortium. Through CISNET, SimCRC has been used to inform several national policy and Medicare coverage decisions surrounding colorectal cancer screening:

Of note, Dr. Knudsen’s team led CISNET analyses that helped to inform the US Preventive Task Force’s 2021 recommendation to begin colorectal cancer screening at age 45. The CISNET team developed an interactive tool for viewing model outcomes by the ages to begin and end screening.

Model schematic of the natural history of colorectal cancer and the effects of screening as simulated by the Simulation Model of ColoRectal Cancer (SimCRC).

Flowchart showing how the simulation model of colorectal cancer (SimCRC) simulates the natural history of colorectal cancer and the effects of screening
Source: Knudsen et al. JAMA 2021


2021

Knudsen, Amy; Rutter, Carolyn M; Meester, Reinier G S; Lansdorp-Vogelaar, Iris; Zauber, Ann G; Kuntz, Karen M

Colorectal Cancer Screening in Young Adults. Journal Article

In: Annals of internal medicine, vol. 174, no. 7, pp. 1039–1040, 2021, ISSN: 1539-3704, ().

Links | BibTeX

Knudsen, Amy; Rutter, Carolyn M.; Peterse, Elisabeth F. P.; Lietz, Anna; Seguin, Claudia; Meester, Reinier G. S.; Perdue, Leslie A.; Lin, Jennifer S.; Siegel, Rebecca L.; Doria-Rose, V. Paul; Feuer, Eric J.; Zauber, Ann G.; Kuntz, Karen M.; Lansdorp-Vogelaar, Iris

Colorectal Cancer Screening: An Updated Modeling Study for the US Preventive Services Task Force Journal Article

In: JAMA, vol. 325, no. 19, pp. 1998-2011, 2021, ISSN: 0098-7484, ().

Abstract | Links | BibTeX

Peterse, Elisabeth F. P.; Meester, Reinier G. S.; Jonge, Lucie; Omidvari, Amir-Houshang; Alarid-Escudero, Fernando; Knudsen, Amy; Zauber, Ann G.; Lansdorp-Vogelaar, Iris

Comparing the cost-effectiveness of innovative colorectal cancer screening tests. Journal Article

In: Journal of the National Cancer Institute, vol. 113, no. 2, pp. 154-161, 2021, ISSN: 1460-2105, ().

Abstract | Links | BibTeX

Rutter, Carolyn M.; Knudsen, Amy; Lin, Jennifer S.; Bouskill, Kathryn E.

Black and White Differences in Colorectal Cancer Screening and Screening Outcomes: A Narrative Review. Journal Article

In: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, vol. 30, no. 1, pp. 3-12, 2021, ISSN: 1538-7755, ().

Abstract | Links | BibTeX

Seguin, Claudia; Lietz, Anna; Wright, Jason D.; Wright, Alexi; Knudsen, Amy; Pandharipande, Pari

Surveillance in Older Women With Incidental Ovarian Cysts: Maximal Projected Benefits by Age and Comorbidity Level. Journal Article

In: Journal of the American College of Radiology : JACR, vol. 18, no. 1 PT A, pp. 10-18, 2021, ISSN: 1558-349X, ().

Abstract | Links | BibTeX

2020

DeYoreo, Maria; Lansdorp-Vogelaar, Iris; Knudsen, Amy; Kuntz, Karen M.; Zauber, Ann G.; Rutter, Carolyn M.

Validation of Colorectal Cancer Models on Long-Term Outcomes from a Randomized Controlled Trial. Journal Article

In: Medical decision making : an international journal of the Society for Medical Decision Making, vol. 40, no. 8, pp. 1034-1040, 2020, ISSN: 1552-681X, ().

Abstract | Links | BibTeX

Abuelo, Carolina; Ashburner, Jeffrey M.; Atlas, Steven J.; Knudsen, Amy; Morrill, James; Corona, Patricia; Shtasel, Derri; Percac-Lima, Sanja

Colorectal Cancer Screening Patient Navigation for Patients with Mental Illness and/or Substance Use Disorder: Pilot Randomized Control Trial. Journal Article

In: Journal of dual diagnosis, vol. 16, no. 4, pp. 438-446, 2020, ISSN: 1550-4271, ().

Abstract | Links | BibTeX

Meester, Reinier G. S.; Lansdorp-Vogelaar, Iris; Winawer, Sidney J.; Zauber, Ann G.; Knudsen, Amy; Ladabaum, Uri

Intensity of Surveillance for Patients With Colorectal Adenomas. Journal Article

In: Annals of internal medicine, vol. 172, pp. 442, 2020, ISSN: 1539-3704, ().

Links | BibTeX

Meester, Reinier G. S.; Lansdorp-Vogelaar, Iris; Winawer, Sidney J.; Zauber, Ann G.; Knudsen, Amy; Ladabaum, Uri

Intensity of Surveillance for Patients With Colorectal Adenomas. Journal Article

In: Annals of internal medicine, vol. 172, pp. 442, 2020, ISSN: 1539-3704, ().

Links | BibTeX

2019

Meester, Reinier G S; Lansdorp-Vogelaar, Iris; Winawer, Sidney J; Zauber, Ann G; Knudsen, Amy; Ladabaum, Uri

High-Intensity Versus Low-Intensity Surveillance for Patients With Colorectal Adenomas: A Cost-Effectiveness Analysis. Journal Article

In: Annals of internal medicine, vol. 171, no. 9, pp. 612-622, 2019, ISSN: 1539-3704, ().

Abstract | Links | BibTeX

Weaver, Davis; Lietz, Anna; Mercaldo, Sarah Fletcher; Peters, Mary Linton B.; Hur, Chin; Kong, Chung Yin; Wolpin, Brian M; Megibow, Alec J; Berland, Lincoln L; Knudsen, Amy; Pandharipande, Pari

Testing for Verification Bias in Reported Malignancy Risks for Side-Branch Intraductal Papillary Mucinous Neoplasms: A Simulation Modeling Approach. Journal Article

In: AJR. American journal of roentgenology, vol. 212, no. 3, pp. 596-601, 2019, ISSN: 1546-3141.

Abstract | Links | BibTeX

Chen, Qiushi; Larochelle, Marc R.; Weaver, Davis; Lietz, Anna; Mueller, Peter P.; Mercaldo, Sarah Fletcher; Wakeman, Sarah E.; Freedberg, Kenneth A.; Raphel, Tiana; Knudsen, Amy; Pandharipande, Pari; Chhatwal, Jagpreet

Prevention of Prescription Opioid Misuse and Projected Overdose Deaths in the United States Journal Article

In: JAMA Network Open, vol. 2, no. 2, pp. e187621-e187621, 2019, ISSN: 2574-3805, ().

Abstract | Links | BibTeX

Lietz, Anna; Weaver, Davis; Melamed, Alexander; Rauh-Hain, Jose Alejandro; Wright, Jason D; Wright, Alexi; Knudsen, Amy; Pandharipande, Pari

Potential survival benefits from optimized chemotherapy implementation in advanced ovarian cancer: Projections from a microsimulation model. Journal Article

In: PloS one, vol. 14, pp. e0222828, 2019, ISSN: 1932-6203, ().

Abstract | Links | BibTeX

Naber, Steffie K; Knudsen, Amy; Zauber, Ann G; Rutter, Carolyn M; Fischer, Sara E; Pabiniak, Chester J; Soto, Brittany; Kuntz, Karen M; Lansdorp-Vogelaar, Iris

Cost-effectiveness of a multitarget stool DNA test for colorectal cancer screening of Medicare beneficiaries. Journal Article

In: PloS one, vol. 14, pp. e0220234, 2019, ISSN: 1932-6203, ().

Abstract | Links | BibTeX

2018

Neal, Chrishanae; Weaver, Davis; Raphel, Tiana; Lietz, Anna; Flores, Efren J; Percac-Lima, Sanja; Knudsen, Amy; Pandharipande, Pari

Patient Navigation to Improve Cancer Screening in Underserved Populations: Reported Experiences, Opportunities, and Challenges Journal Article

In: Journal of the American College of Radiology : JACR, vol. 15, no. 11, pp. 1565-1572, 2018, ISSN: 1558-349X, ().

Abstract | Links | BibTeX

Meester, Reinier G S; Peterse, Elisabeth F P; Knudsen, Amy; Weerdt, Anne C; Chen, Jennifer C; Lietz, Anna; Dwyer, Andrea; Ahnen, Dennis J; Siegel, Rebecca L; Smith, Robert A; Zauber, Ann G; Lansdorp-Vogelaar, Iris

Optimizing colorectal cancer screening by race and sex: Microsimulation analysis II to inform the American Cancer Society colorectal cancer screening guideline. Journal Article

In: Cancer, vol. 124, no. 15, pp. 2974-2985, 2018, ISSN: 1097-0142, ().

Abstract | Links | BibTeX

Weaver, Davis; Raphel, Tiana; Melamed, Alexander; Rauh-Hain, Jose Alejandro; Schorge, John O; Knudsen, Amy; Pandharipande, Pari

Modeling treatment outcomes for patients with advanced ovarian cancer: Projected benefits of a test to optimize treatment selection. Journal Article

In: Gynecologic oncology, vol. 149, no. 2, pp. 256-262, 2018, ISSN: 1095-6859, ().

Abstract | Links | BibTeX

Raphel, Tiana; Weaver, Davis; Berland, Lincoln L; Herts, Brian R; Megibow, Alec J; Knudsen, Amy; Pandharipande, Pari

Imaging Follow-up of Low-Risk Incidental Pancreas and Kidney Findings: Effects of Patient Age and Comorbidity on Projected Life Expectancy. Journal Article

In: Radiology, vol. 287, no. 2, pp. 504-514, 2018, ISSN: 1527-1315, ().

Abstract | Links | BibTeX

2016

Rutter, Carolyn M.; Knudsen, Amy; Marsh, Tracey L.; Doria-Rose, V Paul; Johnson, Eric; Pabiniak, Chester; Kuntz, Karen M.; Ballegooijen, Marjolein; Zauber, Ann G.; Lansdorp-Vogelaar, Iris

Validation of Models Used to Inform Colorectal Cancer Screening Guidelines: Accuracy and Implications Journal Article

In: Med Decis Making, vol. 36, no. 5, pp. 604-14, 2016, ().

Abstract | Links | BibTeX

Knudsen, Amy; Zauber, Ann G.; Rutter, Carolyn M.; Naber, Steffie K.; Doria-Rose, V Paul; Pabiniak, Chester; Johanson, Colden; Fischer, Sara E.; Lansdorp-Vogelaar, Iris; Kuntz, Karen M.

Estimation of Benefits, Burden, and Harms of Colorectal Cancer Screening Strategies: Modeling Study for the US Preventive Services Task Force Journal Article

In: JAMA, vol. 315, no. 23, pp. 2595–2609, 2016, ().

Abstract | Links | BibTeX

2015

Goede, Simon L.; Kuntz, Karen M.; Ballegooijen, Marjolein; Knudsen, Amy; Lansdorp-Vogelaar, Iris; Tangka, Florence K.; Howard, David H.; Chin, Joseph; Zauber, Ann G.; Seeff, Laura C.

Cost-Savings to Medicare From Pre-Medicare Colorectal Cancer Screening Journal Article

In: Med Care, vol. 53, no. 7, pp. 630–638, 2015, ().

Abstract | Links | BibTeX

Steen, Alex; Knudsen, Amy; Hees, Frank; Walter, Gailya P.; Berger, Franklin G.; Daguise, Virginie G.; Kuntz, Karen M.; Zauber, Ann G.; Ballegooijen, Marjolein; Lansdorp-Vogelaar, Iris

Optimal colorectal cancer screening in states' low-income, uninsured populations-the case of South Carolina Journal Article

In: Health Serv Res, vol. 50, no. 3, pp. 768–789, 2015, ().

Abstract | Links | BibTeX

2013

Rutter, Carolyn M.; Johnson, Eric A.; Feuer, Eric J.; Knudsen, Amy; Kuntz, Karen M.; Schrag, Deborah

Secular Trends in Colon and Rectal Cancer Relative Survival Journal Article

In: J Natl Cancer Inst, vol. 105, no. 23, pp. 1806-13, 2013, ().

Abstract | Links | BibTeX

2012

Knudsen, Amy; Hur, Chin; Gazelle, G. Scott; Schrag, Deborah; McFarland, Elizabeth G.; Kuntz, Karen M.

Rescreening of persons with a negative colonoscopy result: results from a microsimulation model Journal Article

In: Ann Intern Med, vol. 157, no. 9, pp. 611–620, 2012, ().

Abstract | Links | BibTeX

2011

Vanness, D. J.; Knudsen, Amy; Lansdorp-Vogelaar, I.; Rutter, C. M.; Gareen, I. F.; Herman, B. A.; Kuntz, K. M.; Zauber, A. G.; Ballegooijen, M.; Feuer, E. J.; Chen, M. H.; Johnson, C. D.

Comparative economic evaluation of data from the ACRIN National CT Colonography Ŧrial with three cancer intervention and surveillance modeling network microsimulations Journal Article

In: Radiology, vol. 261, no. 2, pp. 487-98, 2011, ISSN: 1527-1315 (Electronic) 0033-8419, ().

Abstract | Links | BibTeX

Rutter, C. M.; Knudsen, Amy; Pandharipande, Pari

Computer disease simulation models: integrating evidence for health policy Journal Article

In: Acad Radiol, vol. 18, no. 9, pp. 1077-86, 2011, ISSN: 1878-4046 (Electronic) 1076-6332, ().

Abstract | Links | BibTeX

Lansdorp-Vogelaar, I.; Knudsen, Amy; Brenner, H.

Cost-effectiveness of colorectal cancer screening Journal Article

In: Epidemiol Rev, vol. 33, no. 1, pp. 88-100, 2011, ISSN: 1478-6729 (Electronic) 0193-936X, ().

Abstract | Links | BibTeX

Haug, U.; Kuntz, K. M.; Knudsen, Amy; Hundt, S.; Brenner, H.

Sensitivity of immunochemical faecal occult blood testing for detecting left- vs right-sided colorectal neoplasia Journal Article

In: Br J Cancer, vol. 104, no. 11, pp. 1779-85, 2011, ISSN: 1532-1827 (Electronic) 0007-0920, ().

Abstract | Links | BibTeX

Gonzalez, A. Berrington; Kim, K. P.; Knudsen, Amy; Lansdorp-Vogelaar, I.; Rutter, C. M.; Smith-Bindman, R.; Yee, J.; Kuntz, K. M.; Ballegooijen, M.; Zauber, A. G.; Berg, C. D.

Radiation-related cancer risks from CT colonography screening: a risk-benefit analysis Journal Article

In: AJR Am J Roentgenol, vol. 196, no. 4, pp. 816-23, 2011, ISSN: 1546-3141 (Electronic) 0361-803X, ().

Abstract | Links | BibTeX

Stock, C.; Knudsen, Amy; Lansdorp-Vogelaar, I.; Haug, U.; Brenner, H.

Colorectal cancer mortality prevented by use and attributable to nonuse of colonoscopy Journal Article

In: Gastrointest Endosc, vol. 73, pp. 435-443 e5, 2011, ().

Abstract | Links | BibTeX

Ballegooijen, M.; Rutter, C. M.; Knudsen, Amy; Zauber, A. G.; Savarino, J. E.; Lansdorp-Vogelaar, I.; Boer, R.; Feuer, E. J.; Habbema, J. D.; Kuntz, K. M.

Clarifying differences in natural history between models of screening: the case of colorectal cancer Journal Article

In: Med Decis Making, vol. 31, pp. 540-9, 2011, ().

Abstract | Links | BibTeX

Kuntz, K. M.; Lansdorp-Vogelaar, I.; Rutter, C. M.; Knudsen, Amy; Ballegooijen, M.; Savarino, J. E.; Feuer, E. J.; Zauber, A. G.

A systematic comparison of microsimulation models of colorectal cancer: the role of assumptions about adenoma progression Journal Article

In: Med Decis Making, vol. 31, pp. 530-9, 2011, ().

Abstract | Links | BibTeX

Haug, U.; Knudsen, Amy; Brenner, H.; Kuntz, K. M.

Is fecal occult blood testing more sensitive for left- versus right-sided colorectal neoplasia? A systematic literature review Journal Article

In: Expert Rev Mol Diagn, vol. 11, pp. 605–16, 2011, ISSN: 1744-8352 (Electronic) 1473-7159, ().

Abstract | Links | BibTeX

2010

Lansdorp-Vogelaar, I.; Kuntz, K. M.; Knudsen, Amy; Wilschut, J. A.; Zauber, A. G.; Ballegooijen, M.

Stool DNA testing to screen for colorectal cancer in the Medicare population: a cost-effectiveness analysis Journal Article

In: Ann Intern Med, vol. 153, no. 6, pp. 368-77, 2010, ISSN: 1539-3704 (Electronic) 0003-4819, ().

Abstract | Links | BibTeX

Knudsen, Amy; Lansdorp-Vogelaar, I.; Rutter, C. M.; Savarino, J. E.; Ballegooijen, M.; Kuntz, K. M.; Zauber, A. G.

Cost-effectiveness of computed tomographic colonography screening for colorectal cancer in the medicare population Journal Article

In: J Natl Cancer Inst, vol. 102, no. 16, pp. 1238-52, 2010, ISSN: 1460-2105 (Electronic) 0027-8874, ().

Abstract | Links | BibTeX

Lansdorp-Vogelaar, I.; Knudsen, Amy; Brenner, H.

Cost-effectiveness of colorectal cancer screening - an overview Journal Article

In: Best Pract Res Clin Gastroenterol, vol. 24, no. 4, pp. 439-49, 2010, ISSN: 1532-1916 (Electronic) 1521-6918, ().

Abstract | Links | BibTeX

2009

Greenblatt, Wesley; Hur, Chin; Knudsen, Amy; Evans, J. A.; Chung, D. C.; Gazelle, G. Scott

Cost-effectiveness of prophylactic surgery for duodenal cancer in familial adenomatous polyposis Journal Article

In: Cancer Epidemiol Biomarkers Prev, vol. 18, no. 10, pp. 2677-84, 2009, ISSN: 1538-7755 (Electronic) 1055-9965, ().

Abstract | Links | BibTeX

Stout, N. K.; Knudsen, Amy; Kong, Chung Yin; McMahon, Pamela M.; Gazelle, G. Scott

Calibration methods used in cancer simulation models and suggested reporting guidelines Journal Article

In: PharmacoEconomics, vol. 27, pp. 533-45, 2009, ().

Abstract | Links | BibTeX

2008

Zauber, A. G.; Lansdorp-Vogelaar, I.; Knudsen, Amy; Wilschut, J.; Ballegooijen, M.; Kuntz, K. M.

Evaluating test strategies for colorectal cancer screening: a decision analysis for the U.S. Preventive Services Task Force Journal Article

In: Ann Intern Med, vol. 149, no. 9, pp. 659-69, 2008, ISSN: 1539-3704 (Electronic) 0003-4819, ().

Abstract | Links | BibTeX

Pearson, Steven; Knudsen, Amy; Scherer, R. W.; Weissberg, J.; Gazelle, G. Scott

Assessing the comparative effectiveness of a diagnostic technology: CT colonography Journal Article

In: Health Aff (Millwood), vol. 27, no. 6, pp. 1503-14, 2008, ISSN: 1544-5208 (Electronic) 0278-2715, ().

Abstract | Links | BibTeX

2007

Knudsen, Amy; McMahon, Pamela M.; Gazelle, G. Scott

Use of modeling to evaluate the cost-effectiveness of cancer screening programs Journal Article

In: J Clin Oncol, vol. 25, pp. 203-8, 2007, ().

Abstract | Links | BibTeX