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000154465 037__ $$aDKFZ-2020-00787
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000154465 1001_ $$aChen, Hongda$$b0
000154465 245__ $$aComparative Evaluation of Participation and Diagnostic Yield of Colonoscopy vs Fecal Immunochemical Test vs Risk-Adapted Screening in Colorectal Cancer Screening: Interim Analysis of a Multicenter Randomized Controlled Trial (TARGET-C).
000154465 260__ $$aAlphen aan den Rijn, The Netherlands$$bWolters Kluwer Health, Inc.$$c2020
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000154465 500__ $$aVolume 115, Issue 8, 1 August 2020, Pages 1264-1274
000154465 520__ $$aIn colorectal cancer screening, implementing risk-adapted screening might be more effective than traditional screening strategies. We aimed to compare the effectiveness of a risk-adapted screening strategy with colonoscopy and fecal immunochemical test (FIT) in colorectal cancer screening.A randomized controlled trial was conducted in 6 centers in China since May 2018. Nineteen thousand five hundred forty-six eligible participants aged 50-74 years were recruited and randomly allocated into 1 of the 3 screening groups in a 1:2:2 ratio: (i) one-time colonoscopy (n = 3,916), (ii) annual FIT (n = 7,854), and (iii) annual risk-adapted screening (n = 7,776). Based on the risk-stratification score, high-risk subjects were referred for colonoscopy and low-risk ones were referred for FIT. All subjects with positive FIT were referred for diagnostic colonoscopy. The detection rate of advanced neoplasm was the primary outcome. The study is registered with the China Clinical Trial Registry (www.chictr.org.cn Identifier: ChiCTR1800015506).For baseline screening, the participation rates of the colonoscopy, FIT, and risk-adapted screening groups were 42.5% (1,665/3,916), 94.0% (7,386/7,854), and 85.2% (6,628/7,776), respectively. For the intention-to-screen analysis, the detection rates of advanced neoplasm were 2.40% (94/3,916), 1.13% (89/7,854), and 1.66% (129/7,776), with odds ratios (95% confidence intervals) of 2.16 (1.61-2.90; P < 0.001) for colonoscopy vs FIT, 1.45 (1.10-1.90; P < 0.001) for colonoscopy vs risk-adapted screening, and 1.49 (1.13-1.97; P < 0.001) for risk-adapted screening vs FIT, respectively. The numbers of subjects who required a colonoscopic examination to detect 1 advanced neoplasm were 18 in the colonoscopy group, 10 in the FIT group, and 11 in the risk-adapted screening group.For baseline screening, the risk-adapted screening approach showed a high participation rate, and its diagnostic yield was superior to that of FIT at a similarly low load of colonoscopy.
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000154465 7001_ $$aLu, Ming$$b1
000154465 7001_ $$aLiu, Chengcheng$$b2
000154465 7001_ $$aZou, Shuangmei$$b3
000154465 7001_ $$aDu, Lingbin$$b4
000154465 7001_ $$aLiao, Xianzhen$$b5
000154465 7001_ $$aDong, Dong$$b6
000154465 7001_ $$aWei, Donghua$$b7
000154465 7001_ $$aGao, Yi$$b8
000154465 7001_ $$aZhu, Chen$$b9
000154465 7001_ $$aZhu, Liming$$b10
000154465 7001_ $$aZheng, Weifang$$b11
000154465 7001_ $$aXiao, Haifan$$b12
000154465 7001_ $$aKong, Yunxin$$b13
000154465 7001_ $$aYin, Huiping$$b14
000154465 7001_ $$aZhou, Hai$$b15
000154465 7001_ $$aYing, Rongbiao$$b16
000154465 7001_ $$aWang, Baoquan$$b17
000154465 7001_ $$aZhang, Juan$$b18
000154465 7001_ $$aZhang, Xiaopeng$$b19
000154465 7001_ $$aZhang, Qiang$$b20
000154465 7001_ $$aZhang, Xuan$$b21
000154465 7001_ $$aZhang, Yuhan$$b22
000154465 7001_ $$aWang, Hong$$b23
000154465 7001_ $$aGuo, Lanwei$$b24
000154465 7001_ $$aLiu, Li$$b25
000154465 7001_ $$aRen, Jiansong$$b26
000154465 7001_ $$aShi, Jufang$$b27
000154465 7001_ $$aLi, Ni$$b28
000154465 7001_ $$aMiao, Xiaoping$$b29
000154465 7001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Hermann$$b30$$udkfz
000154465 7001_ $$aDai, Min$$b31
000154465 773__ $$0PERI:(DE-600)2003227-4$$a10.14309/ajg.0000000000000624$$gp. 1 -$$n8$$p1264-1274$$tThe American journal of gastroenterology$$v115$$x0002-9270$$y2020
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