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000182029 041__ $$aEnglish
000182029 082__ $$a610
000182029 1001_ $$00000-0002-1348-3350$$aHeisser, Thomas$$b0$$eFirst author
000182029 245__ $$aMaking colonoscopy-based screening more efficient: a 'gateopener' approach.
000182029 260__ $$aBognor Regis$$bWiley-Liss$$c2023
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000182029 500__ $$a#EA:C070#LA:C070#LA:C120# / 2023 Mar 1;152(5):952-961
000182029 520__ $$aScreening 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.
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000182029 650_7 $$2Other$$acolonoscopy
000182029 650_7 $$2Other$$acolorectal cancer
000182029 650_7 $$2Other$$afecal immunochemical testing
000182029 650_7 $$2Other$$amodelling
000182029 650_7 $$2Other$$ascreening
000182029 7001_ $$00000-0002-9155-7415$$aCardoso, Rafael$$b1
000182029 7001_ $$0P:(DE-He78)20dc4ad11ff465acf5b99f1e679e10b7$$aNiedermaier, Tobias$$b2$$udkfz
000182029 7001_ $$0P:(DE-He78)6c5d058b7552d071a7fa4c5e943fff0f$$aHoffmeister, Michael$$b3$$udkfz
000182029 7001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Hermann$$b4$$eLast author$$udkfz
000182029 773__ $$0PERI:(DE-600)1474822-8$$a10.1002/ijc.34317$$gp. ijc.34317$$n5$$p952-961$$tInternational journal of cancer$$v152$$x0020-7136$$y2023
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