The Influence of Disease Risk on the Optimal Time Interval between Screens for the Early Detection of Cancer: A Mathematical Approach

James O'Mahony, Joost van Rosmalen, NA Mushkudiani, Frans-willem Goudsmit, MJC Eijkemans, Eveline Heijnsdijk, Ewout Steyerberg, Dik Habbema

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)

Abstract

The intervals between screens for the early detection of diseases such as breast and colon cancer suggested by screening guidelines are typically based on the average population risk of disease. With the emergence of ever more biomarkers for cancer risk prediction and the development of personalized medicine, there is a need for risk-specific screening intervals. The interval between successive screens should be shorter with increasing cancer risk. A risk-dependent optimal interval is ideally derived from a cost-effectiveness analysis using a validated simulation model. However, this is time-consuming and costly. We propose a simplified mathematical approach for the exploratory analysis of the implications of risk level on optimal screening interval. We develop a mathematical model of the optimal screening interval for breast cancer screening. We verified the results by programming the simplified model in the MISCAN-Breast microsimulation model and comparing the results. We validated the results by comparing them with the results of a full, published MISCAN-Breast cost-effectiveness model for a number of different risk levels. The results of both the verification and validation were satisfactory. We conclude that the mathematical approach can indicate the impact of disease risk on the optimal screening interval.
Original languageUndefined/Unknown
Pages (from-to)183-195
Number of pages13
JournalMedical Decision Making
Volume35
Issue number2
DOIs
Publication statusPublished - 2015

Research programs

  • EMC NIHES-01-66-01
  • EMC NIHES-02-65-01

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