Personalizing Post-Polypectomy Surveillance for Colorectal Cancer Prevention

Despite strong guidance supporting colorectal cancer screening initiation at age 45-50, relatively little is known about what to do for the subsequent 30+ years after screening. The goals of this proposal are to develop and internally validate a clinical (e.g., age, sex, body mass index, family history of colorectal cancer) and endoscopic (e.g., polyp findings) risk score to predict advanced neoplasia after screening; and determine the added value of incorporating a polygenic risk score to this model; validate the performance of the comprehensive risk model using an independent dataset with complete genetic data, and prior screening and clinicopathologic data; identify the optimal strategy for surveillance using information from Aims 1-2 by modeling within the established microsimulation model; and engage key stakeholders (i.e., patients, providers, and healthcare administrators) of the model and elicit their willingness on implementing this tool in clinical practice.

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