A general model for evaluation of colorectal cancer screening has been impl
emented in the microsimulation program MISCAN-COLON. A large number of fict
itious individual life histories are simulated in each of which several col
orectal lesions can emerge. Next, screening for colorectal cancer is simula
ted, which will change some of the life histories. The demographic characte
ristics, the epidemiology and natural history of the disease, and the chara
cteristics of screening are defined in the input. All kinds of assumptions
on the natural history of colorectal cancer and screening and surveillance
strategies can easily be incorporated in the model. MISCAN-COLON gives deta
iled output of incidence, prevalence and mortality, and the results and eff
ects of screening. It can be used to test hypotheses about the natural hist
ory of colorectal cancer, such as the duration of progressive adenomas, and
screening characteristics, such as sensitivity of tests, against empirical
data. In decision making about screening, the model can be used for evalua
tion of screening policies, and for choosing between competing policies by
comparing their simulated incremental costs and effectiveness outcomes. (C)
1999 Academic Press.