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Creating Simulated Equivalents to Project Long-Term Population Health Outcomes of Underserved Patients: An Application to Colorectal Cancer Screening

Simulation models can be used to project the impact of interventions on long-term population health outcomes. To project the value of an intervention in a specific population, the model must be able to simulate individuals with similar characteristics and pathways as the population receiving the intervention. We aimed to estimate the long-term colorectal cancer (CRC) outcomes (cancers and deaths averted, life-years gained) associated with receipt of a first CRC screening through the Colorectal Cancer Control Program (CRCCP) among low-income and underserved patients in the U.S. We recalibrate a simulation model previously calibrated based on a real-world mix of insurance and demographic factors for a particular state. We describe our strategy for developing simulated equivalents in terms of demographics, natural history, and CRC screening results for the CRCCP patients and matching these patients to their simulated equivalents. We then project lifetime CRC incidence and mortality with and without intervention.