Evaluating a blood test for Colon cancer screening: how simulation modeling can inform clinical policy making and research
Menée aux Etats-Unis à l'aide de 3 modèles de simulation, cette étude estime le rapport coût-efficacité d'un test sanguin de détection du cancer colorectal par rapport à un test FIT annuel, une coloscopie décennale ou à l'absence de dépistage
Screening for colorectal cancer (CRC) has been shown to reduce cancer specific mortality in several randomized controlled clinical trials (RCT) involving stool blood tests and endoscopy. Absent direct evidence from RCTs, new screening tests are often evaluated by simulation modeling that can project impact on outcome. Blood tests for CRC, measuring tumor-associated analytes including from DNA, RNA, and proteins, may provide improved convenience and adherence compared to current tests, but cancer signal may be diluted compared to stool-based tests or direct examination by colonoscopy. Colonoscopy serves as a primary screening test and also in follow-up when a triage test, stool-based or blood-based, is positive.
Journal of the National Cancer Institute , éditorial en libre accès, 2023