Discrete event simulation applied to prediction of future demand of colonoscopies

Abstract

Discrete event simulation was used to model a population-based colorectal cancer screening program. The demand of colonoscopies, including colonoscopies after a positive fecal-occult blood test and surveillance colonoscopies after a premalignant finding, were estimated, with a special focus on sensitivity analysis on the main factors affecting colonosocopy demand and territorial predictions according to the incoming extension of the Program in all regions of Catalonia. Results of the sensitivity analysis showed that FIT positivity is far the most sensitive variable. Territorial results were calculated for each endoscopic unit of Catalonia and an interactive and user-friendly application was developed to make results available to decision-makers. The model predicts a relevant increase in future demand of colonoscopies and, thus, raises the need of careful planning of healthcare resources.