Abstract：
To facilitate informed decision making on participating in colorectal cancer (CRC) screening, we assessed the benefit-harm balance of CRC screening for a wide range of subgroups over different time horizons.
The study combined incidence proportions of benefits and harms of (not) participating in CRC screening estimated by the Adenoma and Serrated pathway to CAncer microsimulation model, a preference eliciting survey, and benefit-harm balance modeling combining all outcomes to determine the net health benefit of CRC screening over 10, 20, and 30 years. Probability of net health benefit was estimated for 210 different subgroups based on age, sex, previous participation in CRC screening, and lifestyle.
CRC screening was net beneficial in 183 of 210 subgroups over 30 years (median probability [MP] of 0.79, interquartile range [IQR] of 0.69-0.85) across subgroups. Net health benefit was greater for men (MP 0.82; IQR 0.69-0.89) than women (MP 0.76; IQR 0.67-0.83) and for those without history of participation in previous screenings (MP 0.84; IQR 0.80-0.89) compared with those with (MP 0.69; IQR 0.59-0.75). Net health benefit decreased with increasing age, from MP of 0.84 (IQR 0.80-0.86) at age 55 to 0.61 (IQR 0.56-0.71) at age 75. Shorter time horizons led to lower benefit, with MP of 0.70 (IQR 0.62-0.80) over 20 years and 0.54 (IQR 0.48-0.67) over 10 years.
Our benefit-harm analysis provides information about net health benefit of screening participation, based on important characteristics and preferences of individuals, which could assist screening invitees in making informed decisions on screening participation.
The study combined incidence proportions of benefits and harms of (not) participating in CRC screening estimated by the Adenoma and Serrated pathway to CAncer microsimulation model, a preference eliciting survey, and benefit-harm balance modeling combining all outcomes to determine the net health benefit of CRC screening over 10, 20, and 30 years. Probability of net health benefit was estimated for 210 different subgroups based on age, sex, previous participation in CRC screening, and lifestyle.
CRC screening was net beneficial in 183 of 210 subgroups over 30 years (median probability [MP] of 0.79, interquartile range [IQR] of 0.69-0.85) across subgroups. Net health benefit was greater for men (MP 0.82; IQR 0.69-0.89) than women (MP 0.76; IQR 0.67-0.83) and for those without history of participation in previous screenings (MP 0.84; IQR 0.80-0.89) compared with those with (MP 0.69; IQR 0.59-0.75). Net health benefit decreased with increasing age, from MP of 0.84 (IQR 0.80-0.86) at age 55 to 0.61 (IQR 0.56-0.71) at age 75. Shorter time horizons led to lower benefit, with MP of 0.70 (IQR 0.62-0.80) over 20 years and 0.54 (IQR 0.48-0.67) over 10 years.
Our benefit-harm analysis provides information about net health benefit of screening participation, based on important characteristics and preferences of individuals, which could assist screening invitees in making informed decisions on screening participation.
摘要：
目的：为了促进参与结直肠癌（CRC）筛查的知情决策，我们评估了不同时间范围内各种亚组的CRC筛查的利弊平衡.
方法：该研究将（不）参与CRC筛查的益处和危害的发生率比例结合起来，通过腺瘤和锯齿状途径估计到CAncer微模拟模型，偏好引发调查，和利益-损害平衡模型结合所有结果，以确定CRC筛查10、20和30年的净健康益处。根据年龄估计了210个不同亚组的净健康获益概率，性别,以前参与CRC筛查，和生活方式。
结果：CRC筛查在210个亚组中的183个亚组中在30年内是净有益的（中位概率（MP）为0.79，四分位距（IQR）为0.69-0.85）。男性（MP0.82；IQR0.69-0.89）的净健康益处大于女性（MP0.76；IQR0.67-0.83），而没有既往筛查史的人（MP0.84；IQR0.80-0.89）的净健康益处大于（MP0.69；IQR0.59-0.75）。净健康效益随着年龄的增长而下降，从55岁时的MP为0.84（IQR0.80-0.86）到75岁时的0.61（IQR0.56-0.71）。较短的时间范围导致较低的利益，20年内MP为0.70（IQR0.62-0.80），10年内MP为0.54（IQR0.48-0.67）。
结论：我们的利弊分析提供了有关参与筛查的净健康益处的信息，根据个人的重要特征和偏好，这可以帮助筛选受邀者就筛选参与做出明智的决定。
方法：该研究将（不）参与CRC筛查的益处和危害的发生率比例结合起来，通过腺瘤和锯齿状途径估计到CAncer微模拟模型，偏好引发调查，和利益-损害平衡模型结合所有结果，以确定CRC筛查10、20和30年的净健康益处。根据年龄估计了210个不同亚组的净健康获益概率，性别,以前参与CRC筛查，和生活方式。
结果：CRC筛查在210个亚组中的183个亚组中在30年内是净有益的（中位概率（MP）为0.79，四分位距（IQR）为0.69-0.85）。男性（MP0.82；IQR0.69-0.89）的净健康益处大于女性（MP0.76；IQR0.67-0.83），而没有既往筛查史的人（MP0.84；IQR0.80-0.89）的净健康益处大于（MP0.69；IQR0.59-0.75）。净健康效益随着年龄的增长而下降，从55岁时的MP为0.84（IQR0.80-0.86）到75岁时的0.61（IQR0.56-0.71）。较短的时间范围导致较低的利益，20年内MP为0.70（IQR0.62-0.80），10年内MP为0.54（IQR0.48-0.67）。
结论：我们的利弊分析提供了有关参与筛查的净健康益处的信息，根据个人的重要特征和偏好，这可以帮助筛选受邀者就筛选参与做出明智的决定。
