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001     182029
005     20241220120851.0
024 7 _ |a 10.1002/ijc.34317
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100 1 _ |a Heisser, Thomas
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245 _ _ |a Making colonoscopy-based screening more efficient: a 'gateopener' approach.
260 _ _ |a Bognor Regis
|c 2023
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500 _ _ |a #EA:C070#LA:C070#LA:C120# / 2023 Mar 1;152(5):952-961
520 _ _ |a 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.
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650 _ 7 |a colonoscopy
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650 _ 7 |a colorectal cancer
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650 _ 7 |a fecal immunochemical testing
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650 _ 7 |a modelling
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650 _ 7 |a screening
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700 1 _ |a Cardoso, Rafael
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700 1 _ |a Niedermaier, Tobias
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700 1 _ |a Hoffmeister, Michael
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700 1 _ |a Brenner, Hermann
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773 _ _ |a 10.1002/ijc.34317
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