{
  "unit": "per 1,000 screening colonoscopies, not per year",
  "source": {
    "source": "https://doi.org/10.1056/NEJMoa1311194",
    "full_text": "https://ce.mayo.edu/sites/default/files/New%20England%20Journal%20of%20Medicine%20article.pdf",
    "location": "Figure 1 and Table 2",
    "participants": 9989,
    "age": "50\u201384",
    "cancers": 65,
    "advanced_precancer": 757,
    "nonadvanced_adenomas": 2893,
    "neither_reported": 6274,
    "population": "Average-risk screening participants; enrollment weighted toward ages 65+; no colonoscopy within the previous 9 years.",
    "limitations": "Colonoscopy was the reference test, so misses are not observed. Small serrated lesions are not separately resolved in these aggregate categories. These yields are not standardized to the USPSTF 45\u201375 population."
  },
  "assumptions": {
    "cancer_sensitivity": 0.95,
    "precancer_sensitivity_assumed": 0.85,
    "specificity": 0.86,
    "performance_source": "https://www.ncbi.nlm.nih.gov/books/NBK570821/table/ch2.tab7/"
  },
  "outcomes": {
    "caught_per_1000_exams": 6.507157873661027,
    "missed_per_1000_exams": 0.34248199335058,
    "precancer_detected_per_1000_exams": 365.40194213635,
    "precancer_missed_per_1000_exams": 64.4826956711206,
    "false_positive_interventions_per_1000_exams": 78.8572011255725,
    "true_negatives_per_1000_exams": 484.4085211999453
  },
  "precancer_sensitivity_scenarios": {
    "0.75": {
      "caught_per_1000_exams": 6.507157873661027,
      "missed_per_1000_exams": 0.34248199335058,
      "precancer_detected_per_1000_exams": 365.40194213635,
      "precancer_missed_per_1000_exams": 121.8006473787833,
      "false_positive_interventions_per_1000_exams": 70.83268788649973,
      "true_negatives_per_1000_exams": 435.11508273135536
    },
    "0.85": {
      "caught_per_1000_exams": 6.507157873661027,
      "missed_per_1000_exams": 0.34248199335058,
      "precancer_detected_per_1000_exams": 365.40194213635,
      "precancer_missed_per_1000_exams": 64.4826956711206,
      "false_positive_interventions_per_1000_exams": 78.8572011255725,
      "true_negatives_per_1000_exams": 484.4085211999453
    },
    "0.95": {
      "caught_per_1000_exams": 6.507157873661027,
      "missed_per_1000_exams": 0.34248199335058,
      "precancer_detected_per_1000_exams": 365.40194213635,
      "precancer_missed_per_1000_exams": 19.23168116507103,
      "false_positive_interventions_per_1000_exams": 85.19234315641944,
      "true_negatives_per_1000_exams": 523.3243936751479
    }
  },
  "limitations": "Observed cancer and precancer yields are retained. Cancer misses are inferred. A single assumed 85% person-level precursor sensitivity extrapolates from lesion-level USPSTF inputs; 75\u201395% are scenarios, not confidence limits. True negatives and false positives inherit this uncertain latent prevalence. Small serrated-only lesions may be misclassified in the aggregate reference categories."
}