Dr. Zauber's primary research focus is the impact of screening, surveillance, and chemoprevention on the national burden of colorectal cancer. Her work involves population based modeling to inform health policy and randomized clinical trials. Dr. Zauber leads a multi-center group of microsimulation modelers from the NCI consortium of the Cancer Intervention and Surveillance Modeling Network (CISNET) to address specific health policy questions in colorectal cancer screening. At the request of the United States Preventive Services Task Force (USPSTF) microsimulation modeling of the United States population was used in a decision analysis to assess the age to begin, age to stop, and the intervals of re-testing for colorectal cancer screening for currently recommended tests. The analysis demonstrated that routine colorectal cancer screening examinations can stop at age 75 if the individual has been consistently screened since age 50 without any clinical findings. These results were incorporated into the 2008 USPSTF recommendations. The Centers for Medicare and Medicaid Services requested micro-simulation modeling of the cost-effectiveness of CT colonography for colorectal cancer screening for the general population. This work demonstrated that CT colonography was not cost effective unless its cost was less than half that of colonoscopy or if adherence was significantly higher. The Annual Report to the Nation on Cancer (2009) featured colorectal cancer. Dr. Zauber led the special section in which microsimulation modeling showed that colorectal cancer screening contributed to more than 50% of the reduction in colorectal cancer over the past 25 years and that increased screening utilization can provide for continued reductions in mortality. This work was in collaboration with colleagues at Erasmus Medical Center in the Netherlands. Dr. Zauber is also the Principal Investigator for a multi-center randomized controlled trial of screening colonoscopy compared to a program of annual testing with fecal occult blood tests (National Colonoscopy Study). In addition she continues her assessment of risk factors for adenoma recurrence in the Adenoma Prevention with Celecoxib trial and of long term mortality following colonoscopic polypectomy in the National Polyp Study.
Selected Bibliography
Zauber AG. Quality control for flexible sigmoidoscopy: which polyps count? Gastroenterology 2004;126:1474-1477.
Zauber P, Sabbath-Solitare M, Marotta S, Zauber A, Bishop T. Comparative molecular pathology of sporadic hyperplastic polyps and neoplastic lesions from the same individual. J Clin Pathol 2004: 57:1084-1088
Winawer SJ, Zauber AG, Fletcher RH, Stillman JS, O'Brien MJ, Levin B, Smith RA, Lieberman DA, Burt RW, Levin TR, Bond JH, Brooks D, Byers T, Hyman N, Kirk L, Thorson A, Simmang C, Johnson D, Rex DK. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer: and the American Cancer Society. Joint publication in Gastroenterology 2006:130:1872-85 and CA Cancer J Clin 2006;56:143-59.
Bertagnolli MM, Eagle CJ, Zauber AG, Redston M, Solomon SD, Kim KM, Tang J, Rosenstein RB., Janet Wittes, Ph.D., Donald Corle, M.S., Timothy M. Hess, M.S., G. Mabel Woloj, Ph.D., William F. Anderson, M.D., M.P.H., Jaye L. Viner, M.D., M.P.H., Donya Bagheri, M.S., D.A.B.T., Gary B. Gordon, M.D., Ph.D., Frederic Boisserie, John Burn, M.D., Daniel C. Chung, M.D., Thomas Dewar, M.D., T. Raymond Foley, M.D., Neville Hoffman, M.D., Finlay Macrae, M.D., Ronald E. Pruitt, M.D., John R. Saltzman, M.D., Bruce Salzberg, M.D., Thomas Sylwestrowicz, M.D., Ernest T. Hawk, M.D., M.P.H. for the Adenoma Prevention with Celecoxib (APC) Study Investigators. Prevention of Sporadic Colorectal Adenomas with Celecoxib: Results of a Randomized Trial .N Engl J Med 2006;355:873-84.
Vogelaar I, van Ballegooijen M, Schrag D, Boer R, Winawer SJ, Habbema JDF, Zauber AG. How much can current interventions reduce colorectal cancer mortality in the US? Mortality projections for scenarios of risk factor modification, screening and treatment. Cancer 2006;107:1624-33.
