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Modeling Strategies to Optimize Cancer Screening in USPSTF Guideline-Noncompliant Women.
Taksler, Glen B; Peterse, Elisabeth F P; Willems, Isarah; Ten Haaf, Kevin; Jansen, Erik E L; de Kok, Inge M C M; van Ravesteyn, Nicolien T; de Koning, Harry J; Lansdorp-Vogelaar, Iris.
  • Taksler GB; Cleveland Clinic Community Care, Cleveland Clinic, Cleveland, Ohio.
  • Peterse EFP; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
  • Willems I; Population Health Research Institute, Case Western Reserve University at The MetroHealth System, Cleveland, Ohio.
  • Ten Haaf K; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • Jansen EEL; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • de Kok IMCM; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • van Ravesteyn NT; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • de Koning HJ; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.
  • Lansdorp-Vogelaar I; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.
JAMA Oncol ; 7(6): 885-894, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1206734
Semantic information from SemMedBD (by NLM)
1. Possible PROCESS_OF Woman
Subject
Possible
Predicate
PROCESS_OF
Object
Woman
2. Possible PROCESS_OF Woman
Subject
Possible
Predicate
PROCESS_OF
Object
Woman
ABSTRACT
Importance In 2018, only half of US women obtained all evidence-based cancer screenings. This proportion may have declined during the COVID-19 pandemic because of social distancing, high-risk factors, and fear.

Objective:

To evaluate optimal screening strategies in women who obtain some, but not all, US Preventive Services Task Force (USPSTF)-recommended cancer screenings. Design, Setting, and

Participants:

This modeling study was conducted from January 31, 2017, to July 20, 2020, and used 4 validated mathematical models from the National Cancer Institute's Cancer Intervention and Surveillance Modeling Network using data from 20 million simulated women born in 1965 in the US.

Interventions:

Forty-five screening strategies were modeled that combined breast, cervical, colorectal, and/or lung cancer (LC) screenings; restricted to 1, 2, 3 or 4 screenings per year; or all eligible screenings once every 5 years. Main Outcomes and

Measures:

Modeled life-years gained from restricted cancer screenings as a fraction of those attainable from full compliance with USPSTF recommendations (maximum benefits). Results were stratified by LC screening eligibility (LC-eligible/ineligible). We repeated the analysis with 2018 adherence rates, evaluating the increase in adherence required for restricted screenings to have the same population benefit as USPSTF recommendations.

Results:

This modeling study of 20 million simulated US women found that it was possible to reduce screening intensity to 1 carefully chosen test per year in women who were ineligible for LC screening and 2 tests per year in eligible women while maintaining 94% or more of the maximum benefits. Highly ranked strategies screened for various cancers, but less often than recommended by the USPSTF. For example, among LC-ineligible women who obtained just 1 screening per year, the optimal strategy frequently delayed breast and cervical cancer screenings by 1 year and skipped 3 mammograms entirely. Among LC-eligible women, LC screening was essential; strategies omitting it provided 25% or less of the maximum benefits. The top-ranked strategy restricted to 2 screenings per year was annual LC screening and alternating fecal immunochemical test with mammography (skipping mammograms when due for cervical cancer screening, 97% of maximum benefits). If adherence in a population of LC-eligible women obtaining 2 screenings per year were to increase by 1% to 2% (depending on the screening test), this model suggests that it would achieve the same benefit as USPSTF recommendations at 2018 adherence rates. Conclusions and Relevance This modeling study of 45 cancer screening strategies suggests that women who are noncompliant with cancer screening guidelines may be able to reduce USPSTF-recommended screening intensity with minimal reduction in overall benefits.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Early Detection of Cancer / COVID-19 / Models, Theoretical Type of study: Diagnostic study / Clinical Practice Guide / Prognostic study / Risk factors / Screening study Limits: Female / Humans Language: English Journal: JAMA Oncol Year: 2021 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Early Detection of Cancer / COVID-19 / Models, Theoretical Type of study: Diagnostic study / Clinical Practice Guide / Prognostic study / Risk factors / Screening study Limits: Female / Humans Language: English Journal: JAMA Oncol Year: 2021 Document Type: Article