• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Chronic Disease

Benefits of high-intensity surveillance following colorectal adenoma removal likely outweigh costs

byThomas SuandDeepti Shroff Karhade
September 26, 2019
in Chronic Disease, Gastroenterology, Public Health
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. In this microsimulation model of U.S. patients aged 50-79, high-intensity surveillance following colorectal adenoma provided clinically significant benefits over low-intensity surveillance at acceptable cost.

2. In nearly all evaluated alternative scenarios, the absolute cost-effectiveness of high-intensity surveillance remained under $100,000 per quality-adjusted life-year (QALY) gained. Compared with low-intensity surveillance, high-intensity surveillance cost less than $30,000 per QALY gained.

Evidence Level: 2 (Good)

Study Rundown: Colorectal cancer (CRC) is the 2nd leading cause of cancer death in the United States despite robust evidence pointing toward routine screening as an effective means of decreasing the risk of death through early detection and removal of precancerous adenomas. Current guidelines recommend surveillance after 5-10 years for patients with low-risk adenomas (LRA) and after 3 years for patients with high-risk adenomas (HRA). However, this frequency constitutes a significant strain on resources, prompting discussion regarding cost-effectiveness especially in light of improvements in colonoscopy performance. Previous observational studies have generally neglected the impact of surveillance intensity on risk of cancer death following adenoma resection, and relevant clinical trial results are not expected for several years. Findings from this microsimulation model supported existing guidelines for surveillance frequency for patients with HRAs and served to counterbalance previous modeling studies advocating against surveillance in patients with LRAs. Furthermore, this model suggested that compared to low-intensity surveillance, high-intensity surveillance yields continually increasing returns in the long term at acceptable cost. The main limitation of this study arose as a result of the dearth of long-term randomized trials concerning adenoma recurrence and CRC incidence. Consequently, despite extensive external model validation, it was difficult to accurately predict the course of CRC incidence at an individual level. Additionally, patients with LRAs of atypical topography or histology were not distinguished from their lower-risk counterparts, increasing the group’s overall likelihood of recurrence/incidence and potentially skewing results in favor of high-intensity surveillance.

Click to read the study in Annals of Internal Medicine

Click to read an accompanying editorial in Annals of Internal Medicine

RELATED REPORTS

#VisualAbstract: Encorafenib, Cetuximab, and mFOLFOX6 Improves Survival in BRAF-Mutated Colorectal Cancer

2MM: AI Roundup- AI Cancer Test, Smarter Hospitals, Faster Drug Discovery, and Mental Health Tech [May 2nd, 2025]

Sotorasib plus panitumumab may be a promising treatment option for colorectal cancer

Relevant Reading: Use of Colonoscopy to Screen Asymptomatic Adults for Colorectal Cancer

In-Depth [prospective cohort]: This study utilized a predictive model of CRC representative of average risk U.S. patients aged 50-79 who had adenomas removed at screening with colonoscopy or fecal immunochemical testing. Data was drawn from the NCI Surveillance, Epidemiology, and End Results (SEER) program. In analysis, adenomas were classified as small (<10 mm in diameter) or large (≥10 mm in diameter). Patients with LRAs were defined as having no more than 2 small adenomas, while patients with HRAs were defined as having between 3 and 10 small adenomas or at least one large adenoma. Model detection rates were validated against numerous chemoprevention trials and prospective cohort studies, model incidence predictions were validated against the largest retrospective cohort study on CRC incidence to date, and model mortality predictions were validated against two of the largest, most-cited studies on mortality. Primary study outcomes included lifetime CRC incidence/mortality, quality-adjusted life-years (QALY) gained, and cost-effectiveness ratios. In sensitivity analyses, the vast majority of evaluated scenarios resulted in a cost-effectiveness ratio significantly lower than the threshold, defined as $100,000/QALY gained. The only scenarios to exceed this threshold were high-intensity surveillance of patients with LRAs removed at age 70 years ($103,900/QALY gained) and near-perfect colonoscopy quality ($455,600/QALY gained).

Image: PD

©2019 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: colonoscopycolorectal adenomacolorectal cancerfecal immunochemical testinghigh-risk adenomas
Previous Post

Quick Take: Efficacy and Long-term Peripheral Sensory Neuropathy of 3 vs 6 Months of Oxaliplatin-Based Adjuvant Chemotherapy for Colon Cancer

Next Post

Early revascularization improves survival in patients with ischemia demonstrated on positron emission tomography perfusion imaging

RelatedReports

#VisualAbstract: Encorafenib, Cetuximab, and mFOLFOX6 Improves Survival in BRAF-Mutated Colorectal Cancer
StudyGraphics

#VisualAbstract: Encorafenib, Cetuximab, and mFOLFOX6 Improves Survival in BRAF-Mutated Colorectal Cancer

June 13, 2025
2MM: AI Roundup- AI Cancer Test, Smarter Hospitals, Faster Drug Discovery, and Mental Health Tech [May 2nd, 2025]
AI Roundup

2MM: AI Roundup- AI Cancer Test, Smarter Hospitals, Faster Drug Discovery, and Mental Health Tech [May 2nd, 2025]

May 21, 2025
Benefits of high-intensity surveillance following colorectal adenoma removal likely outweigh costs
Gastroenterology

Sotorasib plus panitumumab may be a promising treatment option for colorectal cancer

April 16, 2025
#VisualAbstract: Invitation to Fecal Immunochemical Test is Noninferior to Colonoscopy Screening in Colorectal Cancer Mortality
StudyGraphics

#VisualAbstract: Invitation to Fecal Immunochemical Test is Noninferior to Colonoscopy Screening in Colorectal Cancer Mortality

April 7, 2025
Next Post
General anesthesia exposure in infants not linked to impaired cognitive development

Early revascularization improves survival in patients with ischemia demonstrated on positron emission tomography perfusion imaging

Insulin costs rose exponentially, regardless of formulation or patent

Insulin discontinuation among patients over 75 more common in healthier patients

Quick Take: Risk of rhabdomyolysis with donepezil compared with rivastigmine or galantamine

Quick Take: Risk of rhabdomyolysis with donepezil compared with rivastigmine or galantamine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Cerebral embolic protection does not decrease stroke incidence in TAVI patients
  • Nerandomilast slows FVC decline in progressive pulmonary fibrosis
  • 2 Minute Medicine: Pharma Roundup – Gastric Immunotherapy Gains, Prostate Pill Expansion, Five-Minute Myeloma Dosing, and Streamlined CAR-T Access [July 8th 2025]
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.