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000181165 1001_ $$aChen, Hongda$$b0
000181165 245__ $$aComparison of Colonoscopy, Fecal Immunochemical Test, and Risk-adapted Approach in a Colorectal Cancer Screening Trial (TARGET-C).
000181165 260__ $$aNew York, NY$$bElsevier Science$$c2023
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000181165 500__ $$aVolume 21, Issue 3, March 2023, Pages 808-818
000181165 520__ $$aThe screening yield and related cost of a risk-adapted screening approach compared with established screening strategies in population-based CRC screening are not clear.We randomly allocated 19,373 participants into one of the three screening arms in a 1:2:2 ratio: (1) one-time colonoscopy (n=3,883); (2) annual fecal immunochemical test (FIT) (n=7,793); (3) annual risk-adapted screening (n=7,697), in which, based on the risk-stratification score, high-risk participants were referred for colonoscopy, and low-risk ones were referred for FIT. Three consecutive screening rounds were conducted for both the FIT and the risk-adapted screening arms. Follow-up to trace the health outcome for all the participants was conducted over the 3-year study period. The detection rate of advanced colorectal neoplasia (CRC and advanced precancerous lesions) was the main outcome. The trial was registered in the Chinese Clinical Trial Registry (number: ChiCTR1800015506).In the colonoscopy, FIT, and risk-adapted screening arms over three screening rounds, the participation rates were 42.4%, 99.3%, and 89.2%, respectively; the detection rates for advanced neoplasm (intention-to-treat analysis) were 2.76%, 2.17%, and 2.35%, respectively, with odds ratio (OR)colonoscopyvs.FIT of 1.27 (95% confidence interval [CI]: 0.99-1.63; P=0.056), ORcolonoscopyvs.risk-adapted screening of 1.17 (95% CI: 0.91-1.49; P=0.218), and ORrisk-adapted screeningvs.FIT of 1.09 (95% CI: 0.88-1.35; P=0.438); the numbers of colonoscopies needed to detect one advanced neoplasm were 15.4, 7.8, and 10.2, respectively; the costs for detecting one advanced neoplasm from a government perspective using package payment format were CNY6,928 ($1,004), CNY5,821 ($844), and CNY6,694 ($970), respectively.The risk-adapted approach is a feasible and cost-favorable strategy for population-based CRC screening, and therefore could complement the well-established one-time colonoscopy and annual repeated FIT screening strategies.
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000181165 650_7 $$2Other$$acolonoscopy
000181165 650_7 $$2Other$$acolorectal cancer screening
000181165 650_7 $$2Other$$afecal immunochemical test
000181165 650_7 $$2Other$$apersonalized screening
000181165 650_7 $$2Other$$arisk stratification
000181165 7001_ $$aShi, Jufang$$b1
000181165 7001_ $$aLu, Ming$$b2
000181165 7001_ $$aLi, Yanjie$$b3
000181165 7001_ $$aDu, Lingbin$$b4
000181165 7001_ $$aLiao, Xianzhen$$b5
000181165 7001_ $$aWei, Donghua$$b6
000181165 7001_ $$aDong, Dong$$b7
000181165 7001_ $$aGao, Yi$$b8
000181165 7001_ $$aZhu, Chen$$b9
000181165 7001_ $$aYing, Rongbiao$$b10
000181165 7001_ $$aZheng, Weifang$$b11
000181165 7001_ $$aYan, Shipeng$$b12
000181165 7001_ $$aXiao, Haifan$$b13
000181165 7001_ $$aZhang, Juan$$b14
000181165 7001_ $$aKong, Yunxin$$b15
000181165 7001_ $$aLi, Furong$$b16
000181165 7001_ $$aZou, Shuangmei$$b17
000181165 7001_ $$aLiu, Chengcheng$$b18
000181165 7001_ $$aWang, Hong$$b19
000181165 7001_ $$aZhang, Yuhan$$b20
000181165 7001_ $$aLu, Bin$$b21
000181165 7001_ $$aLuo, Chenyu$$b22
000181165 7001_ $$aCai, Jie$$b23
000181165 7001_ $$aTian, Jianbo$$b24
000181165 7001_ $$aMiao, Xiaoping$$b25
000181165 7001_ $$aDing, Kefeng$$b26
000181165 7001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Hermann$$b27$$udkfz
000181165 7001_ $$aDai, Min$$b28
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