Recent Highlights: Colorectal

The MISCAN model led a manuscript titled “Effectiveness and Cost-Effectiveness of Colorectal Cancer Screening With a Blood Test That Meets the Centers for Medicare & Medicaid Services Coverage Decision” was accepted for publication in Gastroenterology. In this research, we illustrate with the three CRC CISNET models that even with higher screening uptake, triennial blood-based screening was not projected to be cost-effective compared with established strategies for colorectal cancer. We will also present this work during the Digestive Disease Week in Washington, D.C. in May 2024.

Quality-adjusted life-years (QALYs) gained and net costs with different uptake scenarios for FIT, sDNA-FIT, colonoscopy and blood-based screening. Test characteristics of the blood test were based on the CMS coverage criteria.

The CRC-SPIN team led an analysis which was published in eLife in 2023 entitled, “Projected Long-Term Effects Of Colorectal Cancer Screening Disruptions Following the COVID-19 Pandemic.” This analysis, in conjunction with the MISCAN model, examined the potential impact of disruptions in CRC screening caused by the COVID-19 pandemic. The models illustrate that the discontinuation of CRC screening during the pandemic will have an uneven effect on CRC outcomes depending on how quickly screening is resumed, which may lend to the widening of current CRC-based disparities.

The SIM-CRC team led an analysis which calibrated the natural history model of CRC to simulated epidemiological data with different degrees of uncertainty and obtained the joint posterior distribution of the parameters using a Bayesian approach. The analysis was conducted using the high-performing computing resources running the Extreme-scale Model Exploration with Swift (EMEWS) framework (led by Drs. Ozik and Collier). The team found that different characterizations of uncertainty of calibrated parameters may affect the expected value of eliminating parametric uncertainty on a cost-effectiveness analysis. Ignoring inherent correlation among calibrated parameters on a PSA overestimates the value of uncertainty. "Characterization and Valuation of the Uncertainty of Calibrated Parameters in Microsimulation Decision Models"