Journal Article

DKFZ-2022-02371

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Making colonoscopy-based screening more efficient: a 'gateopener' approach.

Heisser, T. (First author)DKFZ* ; Cardoso, R.DKFZ* ; Niedermaier, T.DKFZ* ; Hoffmeister, M.DKFZ* ; Brenner, H. (Last author)DKFZ*

2023
Wiley-Liss Bognor Regis

This record in other databases:  

Please use a persistent id in citations: doi:10.1002/ijc.34317

Abstract: Screening colonoscopy for early detection and prevention of colorectal cancer (CRC) is mostly used inefficiently. Here, we assessed the potential of an innovative approach to colonoscopy-based screening, by use of a single, low threshold fecal immunochemical test (FIT) as a 'gateopener' for screening colonoscopy. Using COSIMO, a validated simulation model, we modelled scenarios including either direct invitation to screening colonoscopy or an alternative approach involving mailing a single ('gateopener') FIT along with an invitation to colonoscopy contingent on a FIT value above a low threshold yielding a 50% positivity rate (i.e., every other pre-test will be positive). Under plausible assumptions on screening offer adherence, we found that such 'gateopener screening' (use of screening colonoscopy contingent on a positive, low threshold gateopener FIT) approximately doubled cancer detection rates versus conventional screening. In those spared from screening colonoscopy due to a negative gateopener FIT pretest, numbers needed to screen were 10-times higher versus those for individuals with a positive FIT, peaking in >2000 and >3800 (hypothetically) needed colonoscopies to detect one case of cancer in men and women, respectively. Gateopener screening resulted in 42-51% and 59-65% more prevented CRC cases and deaths, respectively. In summary, by directing colonoscopy capacities to those most likely to benefit, offering screening colonoscopy contingent on a 'gateopener' low-threshold FIT would substantially enhance efficiency of colonoscopy screening.

Keyword(s): colonoscopy ; colorectal cancer ; fecal immunochemical testing ; modelling ; screening

Note: #EA:C070#LA:C070#LA:C120# / 2023 Mar 1;152(5):952-961

---

Contributing Institute(s):

1. C070 Klinische Epidemiologie und Alternf. (C070)
2. Präventive Onkologie (C120)
3. DKTK HD zentral (HD01)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2022

---

Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; DEAL Wiley ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

---