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@ARTICLE{Chen:181165,
      author       = {H. Chen and J. Shi and M. Lu and Y. Li and L. Du and X.
                      Liao and D. Wei and D. Dong and Y. Gao and C. Zhu and R.
                      Ying and W. Zheng and S. Yan and H. Xiao and J. Zhang and Y.
                      Kong and F. Li and S. Zou and C. Liu and H. Wang and Y.
                      Zhang and B. Lu and C. Luo and J. Cai and J. Tian and X.
                      Miao and K. Ding and H. Brenner$^*$ and M. Dai},
      title        = {{C}omparison of {C}olonoscopy, {F}ecal {I}mmunochemical
                      {T}est, and {R}isk-adapted {A}pproach in a {C}olorectal
                      {C}ancer {S}creening {T}rial ({TARGET}-{C}).},
      journal      = {Clinical gastroenterology and hepatology},
      volume       = {21},
      number       = {3},
      issn         = {1542-3565},
      address      = {New York, NY},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2022-01818},
      pages        = {808-818},
      year         = {2023},
      note         = {Volume 21, Issue 3, March 2023, Pages 808-818},
      abstract     = {The 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.},
      keywords     = {colonoscopy (Other) / colorectal cancer screening (Other) /
                      fecal immunochemical test (Other) / personalized screening
                      (Other) / risk stratification (Other)},
      cin          = {C070 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35964896},
      doi          = {10.1016/j.cgh.2022.08.003},
      url          = {https://inrepo02.dkfz.de/record/181165},
}