Effect of Time to Diagnostic Testing for Breast, Cervical, and Colorectal Cancer Screening Abnormalities on Screening Efficacy: A Modeling Study

A simulation study (Rutter et al., 2018) was used to estimate the change in lifetime screening benefits when time to follow-up for breast, cervical, and colorectal cancers was increased. Estimates were based on four independently developed microsimulation models that each simulated the life course of adults eligible for screening of breast cancer (women aged 50‒74 years, biennial mammography), cervical cancer (women aged 21‒65 years, triennial Papanicolaou testing), or colorectal cancer (adults aged 50‒75 years, fecal immunochemical test). For each cancer type, diagnostic testing was at 3, 6, and 12 months after an abnormal screening exam. The authors found that longer times to diagnostic testing after an abnormal screening test can decrease the effectiveness of screening, but the impact varied substantially by cancer type. Understanding the impact of time to diagnostic testing on screening effectiveness can help inform quality improvement efforts. Methods and findings are described in more detail in Rutter et al., 2018.