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Activity Number:
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496
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Type:
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Topic Contributed
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Date/Time:
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Thursday, August 10, 2006 : 8:30 AM to 10:20 AM
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Sponsor:
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Section on Statistics in Epidemiology
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| Abstract - #305377 |
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Title:
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Screening with Virtual Colonoscopy: Should Small Polyps Be Referred for Removal?
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Author(s):
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Iris Vogelaar*+ and Marjolein van Ballegooijen and Ann Zauber and J. Dik F. Habbema
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Companies:
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University Medical Center Rotterdam and University Medical Center Rotterdam and Memorial Sloan-Kettering Cancer Center and University Medical Center Rotterdam
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Address:
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P.O. Box 2040, Room AE-103, Rotterdam, 3000 CA, The Netherlands
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Keywords:
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colorectal cancer ; virtual colonoscopy ; cost-effectiveness ; micro-simulation modeling
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Abstract:
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There has been considerable debate as to whether patients with small- or medium-sized polyps detected at virtual colonoscopy (VC) should be referred for immediate diagnostic colonoscopy. We used the MISCAN-Colon microsimulation model to compare the cost-effectiveness of three regimes of referral for diagnostic colonoscopy after screening with VC: persons with any polyp, polyps >= 6 mm, and polyps >= 10 mm detected. Following up on all persons with polyps detected by VC, independent of size, generates the lowest costs per life year saved compared with restricting follow-up to patients with polyps of 6 mm or 10 mm and larger. This result is robust for most changes in screening test characteristics and natural history assumptions. It therefore seems worthwhile to follow-up immediately all patients with polyps detected by VC with diagnostic colonoscopy.
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