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@ARTICLE{Chen:154465,
      author       = {H. Chen and M. Lu and C. Liu and S. Zou and L. Du and X.
                      Liao and D. Dong and D. Wei and Y. Gao and C. Zhu and L. Zhu
                      and W. Zheng and H. Xiao and Y. Kong and H. Yin and H. Zhou
                      and R. Ying and B. Wang and J. Zhang and X. Zhang and Q.
                      Zhang and X. Zhang and Y. Zhang and H. Wang and L. Guo and
                      L. Liu and J. Ren and J. Shi and N. Li and X. Miao and H.
                      Brenner$^*$ and M. Dai},
      title        = {{C}omparative {E}valuation of {P}articipation and
                      {D}iagnostic {Y}ield of {C}olonoscopy vs {F}ecal
                      {I}mmunochemical {T}est vs {R}isk-{A}dapted {S}creening in
                      {C}olorectal {C}ancer {S}creening: {I}nterim {A}nalysis of a
                      {M}ulticenter {R}andomized {C}ontrolled {T}rial
                      ({TARGET}-{C}).},
      journal      = {The American journal of gastroenterology},
      volume       = {115},
      number       = {8},
      issn         = {0002-9270},
      address      = {Alphen aan den Rijn, The Netherlands},
      publisher    = {Wolters Kluwer Health, Inc.},
      reportid     = {DKFZ-2020-00787},
      pages        = {1264-1274},
      year         = {2020},
      note         = {Volume 115, Issue 8, 1 August 2020, Pages 1264-1274},
      abstract     = {In 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.},
      cin          = {C070 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32282342},
      doi          = {10.14309/ajg.0000000000000624},
      url          = {https://inrepo02.dkfz.de/record/154465},
}