Original Research
15 July 2014

Personalizing Age of Cancer Screening Cessation Based on Comorbid Conditions: Model Estimates of Harms and Benefits

Publication: Annals of Internal Medicine
Volume 161, Number 2

Abstract

Background:

Harms and benefits of cancer screening depend on age and comorbid conditions, but reliable estimates are lacking.

Objective:

To estimate the harms and benefits of cancer screening by age and comorbid conditions to inform decisions about screening cessation.

Design:

Collaborative modeling with 7 cancer simulation models and common data on average and comorbid condition level–specific life expectancy.

Setting:

U.S. population.

Patients:

U.S. cohorts aged 66 to 90 years in 2010 with average health or 1 of 4 comorbid condition levels: none, mild, moderate, or severe.

Intervention:

Mammography, prostate-specific antigen testing, or fecal immunochemical testing.

Measurements:

Lifetime cancer deaths prevented and life-years gained (benefits); false-positive test results and overdiagnosed cancer cases (harms). For each comorbid condition level, the age at which harms and benefits of screening were similar to that for persons with average health having screening at age 74 years.

Results:

Screening 1000 women with average life expectancy at age 74 years for breast cancer resulted in 79 to 96 (range across models) false-positive results, 0.5 to 0.8 overdiagnosed cancer cases, and 0.7 to 0.9 prevented cancer deaths. Although absolute numbers of harms and benefits differed across cancer sites, the ages at which to cease screening were consistent across models and cancer sites. For persons with no, mild, moderate, and severe comorbid conditions, screening until ages 76, 74, 72, and 66 years, respectively, resulted in harms and benefits similar to average-health persons.

Limitation:

Comorbid conditions influenced only life expectancy.

Conclusion:

Comorbid conditions are an important determinant of harms and benefits of screening. Estimates of screening benefits and harms by comorbid condition can inform discussions between providers and patients about personalizing screening cessation decisions.

Primary Funding Source:

National Cancer Institute and Centers for Disease Control and Prevention.

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Supplemental Material

Supplement. Tables

References

1.
U.S. Preventive Services Task Force. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149:627-37. [PMID: 18838716]
2.
U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151:716-26. [PMID: 19920272]
3.
Carter HBAlbertsen PCBarry MJEtzioni RFreedland SJGreene KLet al. Early detection of prostate cancer: AUA Guideline. J Urol. 2013;190:419-26. [PMID: 23659877]
4.
Smith RACokkinides VBrawley OW. Cancer screening in the United States, 2012: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2012;:. [PMID: 22261986]
5.
U.S. Census Bureau. 2012 National Population Projections: Table 1. Projected Population by Single Year of Age, Sex, Race, and Hispanic Origin for the United States: 2012 to 2060. Accessed at www.census.gov/population/projections/data/national/2012/downloadablefiles.html on 17 March 2013.
6.
Mandelblatt JSWheat MEMonane MMoshief RDHollenberg JPTang J. Breast cancer screening for elderly women with and without comorbid conditions. A decision analysis model. Ann Intern Med. 1992;116:722-30. [PMID: 1558343]
7.
Walter LCCovinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285:2750-6. [PMID: 11386931]
8.
Tan SYvan Oortmarssen GJde Koning HJBoer RHabbema JD. The MISCAN-Fadia continuous tumor growth model for breast cancer. J Natl Cancer Inst Monogr. 2006;:56-65. [PMID: 17032895]
9.
Mandelblatt JSchechter CBLawrence WYi BCullen J. The SPECTRUM population model of the impact of screening and treatment on U.S. breast cancer trends from 1975 to 2000: principles and practice of the model methods. J Natl Cancer Inst Monogr. 2006;:47-55. [PMID: 17032894]
10.
Draisma GBoer ROtto SJvan der Cruijsen IWDamhuis RASchröder FHet al. Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst. 2003;95:868-78. [PMID: 12813170]
11.
Gulati RInoue LKatcher JHazelton WEtzioni R. Calibrating disease progression models using population data: a critical precursor to policy development in cancer control. Biostatistics. 2010;11:707-19. [PMID: 20530126]
12.
Frazier ALColditz GAFuchs CSKuntz KM. Cost-effectiveness of screening for colorectal cancer in the general population. JAMA. 2000;284:1954-61. [PMID: 11035892]
13.
Rutter CMSavarino JE. An evidence-based microsimulation model for colorectal cancer: validation and application. Cancer Epidemiol Biomarkers Prev. 2010;19:1992-2002. [PMID: 20647403]
14.
Loeve FBoer Rvan Oortmarssen GJvan Ballegooijen MHabbema JD. The MISCAN-COLON simulation model for the evaluation of colorectal cancer screening. Comput Biomed Res. 1999;32:13-33. [PMID: 10066353]
15.
Mandelblatt JSCronin KABailey SBerry DAde Koning HJDraisma Get alBreast Cancer Working Group of the Cancer Intervention and Surveillance Modeling Network. Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms. Ann Intern Med. 2009;151:738-47. [PMID: 19920274]
16.
Zauber AGLansdorp-Vogelaar IKnudsen ABWilschut Jvan Ballegooijen MKuntz KM. Evaluating test strategies for colorectal cancer screening: a decision analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;149:659-69. [PMID: 18838717]
17.
Gulati RGore JLEtzioni R. Comparative effectiveness of alternative prostate-specific antigen—based prostate cancer screening strategies: model estimates of potential benefits and harms. Ann Intern Med. 2013;158:145-53. [PMID: 23381039]
18.
Heijnsdijk EAWever EMAuvinen AHugosson JCiatto SNelen Vet al. Quality-of-life effects of prostate-specific antigen screening. N Engl J Med. 2012;367:595-605. [PMID: 22894572]
19.
Gulati RWever EMTsodikov APenson DFInoue LYKatcher Jet al. What if I don't treat my PSA-detected prostate cancer? Answers from three natural history models. Cancer Epidemiol Biomarkers Prev. 2011;20:740-50. [PMID: 21546365]
20.
Cho HKlabunde CNYabroff KRWang ZMeekins ALansdorp-Vogelaar Iet al. Comorbidity-adjusted life expectancy: a new tool to inform recommendations for optimal screening strategies. Ann Intern Med. 2013;159:667-76. [PMID: 24247672]
21.
Klabunde CNLegler JMWarren JLBaldwin LMSchrag D. A refined comorbidity measurement algorithm for claims-based studies of breast, prostate, colorectal, and lung cancer patients. Ann Epidemiol. 2007;17:584-90. [PMID: 17531502]
22.
Klabunde CNPotosky ALLegler JMWarren JL. Development of a comorbidity index using physician claims data. J Clin Epidemiol. 2000;53:1258-67. [PMID: 11146273]
23.
Lee SJBoscardin WJStijacic-Cenzer IConell-Price JO'Brien SWalter LC. Time lag to benefit after screening for breast and colorectal cancer: meta-analysis of survival data from the United States, Sweden, United Kingdom, and Denmark. BMJ. 2013;346:e8441. [PMID: 23299842]
24.
Harewood GCLawlor GOLarson MV. Incident rates of colonic neoplasia in older patients: when should we stop screening? J Gastroenterol Hepatol. 2006;21:1021-5. [PMID: 16724989]
25.
Ko CWSonnenberg A. Comparing risks and benefits of colorectal cancer screening in elderly patients. Gastroenterology. 2005;129:1163-70. [PMID: 16230070]
26.
Maheshwari SPatel TPatel P. Screening for colorectal cancer in elderly persons: who should we screen and when can we stop? J Aging Health. 2008;20:126-39. [PMID: 18089764]
27.
Mandelblatt JSSchechter CBYabroff KRLawrence WDignam JExtermann Met alBreast Cancer in Older Women Research Consortium. Toward optimal screening strategies for older women. Costs, benefits, and harms of breast cancer screening by age, biology, and health status. J Gen Intern Med. 2005;20:487-96. [PMID: 15987322]
28.
Rich JSBlack WC. When should we stop screening? Eff Clin Pract. 2000;3:78-84. [PMID: 10915327]
29.
Stevens TBurke CA. Colonoscopy screening in the elderly: when to stop? Am J Gastroenterol. 2003;98:1881-5. [PMID: 12907348]
30.
Schonberg MADavis RBMcCarthy EPMarcantonio ER. External validation of an index to predict up to 9-year mortality of community-dwelling adults aged 65 and older. J Am Geriatr Soc. 2011;59:1444-51. [PMID: 21797837]
31.
Schonberg MADavis RBMcCarthy EPMarcantonio ER. Index to predict 5-year mortality of community-dwelling adults aged 65 and older using data from the National Health Interview Survey. J Gen Intern Med. 2009;24:1115-22. [PMID: 19649678]
32.
Yourman LCLee SJSchonberg MAWidera EWSmith AK. Prognostic indices for older adults: a systematic review. JAMA. 2012;307:182-92. [PMID: 22235089]
33.
Dinh TAAlperin PWalter LCSmith R. Impact of comorbidity on colorectal cancer screening cost-effectiveness study in diabetic populations. J Gen Intern Med. 2012;27:730-8. [PMID: 22237663]
34.
Greene KLAlbertsen PCBabaian RJCarter HBGann PHHan Met al. Prostate specific antigen best practice statement: 2009 update. J Urol. 2009;182:2232-41. [PMID: 19781717]
35.
Kawachi MHBahnson RRBarry MCarroll PRCarter HBCatalona WJet alNational Comprehensive Cancer Network. Prostate cancer early detection. Clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2007;5:714-36. [PMID: 17692177]
36.
Qaseem ABarry MJDenberg TDOwens DKShekelle PClinical Guidelines Committee of the American College of Physicians. Screening for prostate cancer: a guidance statement from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2013;158:761-9. [PMID: 23567643]
37.
Wolf AMWender RCEtzioni RBThompson IMD'Amico AVVolk RJet alAmerican Cancer Society Prostate Cancer Advisory Committee. American Cancer Society guideline for the early detection of prostate cancer: update 2010. CA Cancer J Clin. 2010;60:70-98. [PMID: 20200110]
38.
Mandelblatt JSTosteson ANvan Ravesteyn NT. Costs, evidence, and value in the Medicare program: the challenges of technology innovation in breast cancer prevention and control. JAMA Intern Med. 2013;173:227-8. [PMID: 23303388]
39.
Begg CB. Comments and response on the USPSTF recommendation on screening for breast cancer [Letter]. Ann Intern Med. 2010;152:540-1. [PMID: 20157101]
40.
Braithwaite RS. Comments and response on the USPSTF recommendation on screening for breast cancer [Letter]. Ann Intern Med. 2010;152:539-40. [PMID: 20157104]
41.
Col NFHansen MHFischhoff BPauker SG. Comments and response on the USPSTF recommendation on screening for breast cancer [Letter]. Ann Intern Med. 2010;152:542. [PMID: 20157100]
42.
Harris RSawaya GFMoyer VACalonge N. Reconsidering the criteria for evaluating proposed screening programs: reflections from 4 current and former members of the U.S. Preventive services task force. Epidemiol Rev. 2011;33:20-35. [PMID: 21666224]
43.
Ho A. Comments and response on the USPSTF recommendation on screening for breast cancer [Letter]. Ann Intern Med. 2010;152:542-3. [PMID: 20157107]
44.
Klijs BMackenbach JPKunst AE. Obesity, smoking, alcohol consumption and years lived with disability: a Sullivan life table approach. BMC Public Health. 2011;11:378. [PMID: 21605473]
45.
Chang YSchechter CBvan Ravesteyn NTNear AMHeijnsdijk EAAdams-Campbell Let al. Collaborative modeling of the impact of obesity on race-specific breast cancer incidence and mortality. Breast Cancer Res Treat. 2012;136:823-35. [PMID: 23104221]
46.
Huxley RRAnsary-Moghaddam AClifton PCzernichow SParr CLWoodward M. The impact of dietary and lifestyle risk factors on risk of colorectal cancer: a quantitative overview of the epidemiological evidence. Int J Cancer. 2009;125:171-80. [PMID: 19350627]
47.
Nelson NJ. Studies on how lifestyle factors may affect breast cancer risk and recurrence. J Natl Cancer Inst. 2012;104:574-6. [PMID: 22472545]
48.
Wolk A. Diet, lifestyle and risk of prostate cancer. Acta Oncol. 2005;44:277-81. [PMID: 16076700]
49.
Gong ZNeuhouser MLGoodman PJAlbanes DChi CHsing AWet al. Obesity, diabetes, and risk of prostate cancer: results from the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev. 2006;15:1977-83. [PMID: 17035408]
50.
Warren JLKlabunde CNMariotto ABMeekins ATopor MBrown MLet al. Adverse events after outpatient colonoscopy in the Medicare population. Ann Intern Med. 2009;150:849-57, W152. [PMID: 19528563]

Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 161Number 215 July 2014
Pages: 104 - 112

History

Published online: 15 July 2014
Published in issue: 15 July 2014

Keywords

Authors

Affiliations

Iris Lansdorp-Vogelaar, PhD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Roman Gulati, MS
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Angela B. Mariotto, PhD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Clyde B. Schechter, MD, MA
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Tiago M. de Carvalho, MSc
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Amy B. Knudsen, PhD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Nicolien T. van Ravesteyn, PhD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Eveline A.M. Heijnsdijk, PhD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Chester Pabiniak, MSc
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Marjolein van Ballegooijen, MD, PhD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Carolyn M. Rutter, PhD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Karen M. Kuntz, ScD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Eric J. Feuer, PhD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Ruth Etzioni, PhD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Harry J. de Koning, MD, PhD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Ann G. Zauber, PhD
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Jeanne S. Mandelblatt, MD, MPH
From Erasmus University Medical Center, Rotterdam, the Netherlands; Fred Hutchinson Cancer Research Center and Group Health Research Institute, Seattle, Washington; National Cancer Institute, Bethesda, Maryland; Albert Einstein College of Medicine, Yeshiva University, Bronx, New York; Massachusetts General Hospital, Boston, Massachusetts; University of Minnesota, Minneapolis, Minnesota; Memorial Sloan Kettering Cancer Center, New York, New York; and Georgetown University, Washington, DC.
Disclaimer: The content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health, the National Cancer Institute, or the Centers for Disease Control and Prevention.
Acknowledgment: The authors thank Drs. Hyunsoon Cho, Carrie Klabunde, and Robin Yabroff from the National Cancer Institute for their permission to use the comorbid condition–specific life tables.
Grant Support: By the National Cancer Institute at the National Institutes of Health and the Centers for Disease Control and Prevention (grants U01CA097426, U01CA115953, U01CA152959, U01CA157224, U01CA088283, and U01CA152958) and in part by the National Cancer Institute at the National Institutes of Health (grants KO5CA96940 to Dr. Mandelblatt and P01CA154292 to Drs. Mandelblatt, Schechter, van Ravesteyn, Heijnsdijk, and de Koning), the Dutch Cancer Society (grants 94-869, 98-1657, 2002-277, and 2006-3518 to Drs. Heijnsdijk and de Koning), and the Netherlands Organisation for Health Research and Development (grants 002822820, 22000106, and 50-50110-98-311 to Drs. Heijnsdijk and de Koning). Breast Cancer Surveillance Consortium data collection and sharing used in some variables for modeling breast cancer screening was supported by the National Cancer Institute at the National Institutes of Health (grants U01CA63740, U01CA86076, U01CA86082, U01CA63736, U01CA70013, U01CA69976, U01CA63731, U01CA70040, and HHSN261201100031C).
Reproducible Research Statement: Study protocol and data set: Available from Dr. Lansdorp-Vogelaar (e-mail, [email protected]). Statistical code: Model profiles are available at http://cisnet.cancer.gov/profiles, and additional information is available from Dr. Lansdorp-Vogelaar (e-mail, [email protected]).
Corresponding Author: Iris Lansdorp-Vogelaar, PhD, Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands; e-mail, [email protected].
Current Author Addresses: Drs. Lansdorp-Vogelaar, van Ravesteyn, Heijnsdijk, van Ballegooijen, and de Koning and Mr. de Carvalho: Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
Mr. Gulati and Dr. Etzioni: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M2-B230, Seattle, WA, 98109-1024.
Dr. Mariotto: Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892.
Dr. Schechter: Department of Family and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461.
Dr. Knudsen: Institute for Technology Assessment, Massachusetts General Hospital, 101 Merrimac Street, 10th Floor, Boston, MA 02114.
Mr. Pabiniak and Dr. Rutter: Group Health Research Institute, 1630 Minor Avenue, Seattle, WA 98101.
Dr. Kuntz: Division of Health Policy and Management, School of Public Health, University of Minnesota, 420 Delaware Street Southeast, Minneapolis, MN 55455.
Dr. Feuer: Statistical Methodology and Applications Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892.
Dr. Zauber: Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 East 63rd Street, Room 357, New York, NY 10065.
Dr. Mandelblatt: Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Boulevard, Washington, DC 20007.
Author Contributions: Conception and design: I. Lansdorp-Vogelaar, C.B. Schechter, N.T. van Ravesteyn, M. van Ballegooijen, E.J. Feuer, A.G. Zauber, J.S. Mandelblatt.
Analysis and interpretation of the data: I. Lansdorp-Vogelaar, R. Gulati, A.B. Mariotto, C.B. Schechter, T.M. de Carvalho, A.B. Knudsen, N.T. van Ravesteyn, E.A.M. Heijnsdijk, C. Pabiniak, C.M. Rutter, K.M. Kuntz, H.J. de Koning, J.S. Mandelblatt.
Drafting of the article: I. Lansdorp-Vogelaar, C.B. Schechter, A.B. Knudsen, A.G. Zauber, J.S. Mandelblatt.
Critical revision of the article for important intellectual content: I. Lansdorp-Vogelaar, R. Gulati, A.B. Mariotto, C.B. Schechter, A.B. Knudsen, N.T. van Ravesteyn, E.A.M. Heijnsdijk, M. van Ballegooijen, K.M. Kuntz, H.J. de Koning, A.G. Zauber, J.S. Mandelblatt.
Final approval of the article: I. Lansdorp-Vogelaar, R. Gulati, A.B. Mariotto, C.B. Schechter, A.B. Knudsen, N.T. van Ravesteyn, E.A.M. Heijnsdijk, C.M. Rutter, M. van Ballegooijen, K.M. Kuntz, E.J. Feuer, R. Etzioni, H.J. de Koning, A.G. Zauber, J.S. Mandelblatt.
Statistical expertise: I. Lansdorp-Vogelaar, R. Gulati, C.B. Schechter, K.M. Kuntz, E.J. Feuer, R. Etzioni, A.G. Zauber.
Obtaining of funding: I. Lansdorp-Vogelaar, M. van Ballegooijen, A.G. Zauber, J.S. Mandelblatt.
Administrative, technical, or logistic support: E.J. Feuer, A.G. Zauber.
Collection and assembly of data: I. Lansdorp-Vogelaar, R. Gulati, A.B. Mariotto, A.B. Knudsen, C. Pabiniak, C.M. Rutter, J.S. Mandelblatt.
* Drs. Zauber and Mandelblatt contributed equally to this work as senior authors.

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Iris Lansdorp-Vogelaar, Roman Gulati, Angela B. Mariotto, et al. Personalizing Age of Cancer Screening Cessation Based on Comorbid Conditions: Model Estimates of Harms and Benefits. Ann Intern Med.2014;161:104-112. [Epub 15 July 2014]. doi:10.7326/M13-2867

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