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@ARTICLE{Brenner:305585,
author = {H. Brenner$^*$ and T. Holland-Letz$^*$ and A.
Kopp-Schneider$^*$ and T. Heisser$^*$ and M.
Hoffmeister$^*$},
title = {{E}arly-detection and prevention effects of screening
sigmoidoscopy: evidence from randomized trials revisited.},
journal = {Journal of the National Cancer Institute},
volume = {nn},
issn = {0027-8874},
address = {Oxford},
publisher = {Oxford Univ. Press},
reportid = {DKFZ-2025-02244},
pages = {nn},
year = {2025},
note = {ISSN 1460-2105 / #EA:M320#LA:C070# / epub},
abstract = {Large-scale randomized controlled trials (RCTs) have
established compelling evidence that screening by flexible
sigmoidoscopy reduces colorectal cancer (CRC) incidence.
Reported incidence results include cancers that were already
prevalent and yet undiagnosed, but no longer preventable at
screening. We aimed to derive, disentangle and fully
disclose early-detection and long-term prevention effects of
screening sigmoidoscopy from published trial results.We used
data from three large-scale RCTs from the United Kingdom
(UKFSST), Italy (SCORE) and the US (PLCO), which included a
total number of 359,198 participants. For each trial and
each length of follow-up, we derived the numbers and
proportions of CRC cases that were either early detected or
prevented among screening attenders.In the UKFSST, which
reported the longest follow-up data, screening sigmoidoscopy
prevented $64\%$ $(95\%$ CI $59-69\%)$ of incident distal
CRC that would have been expected in the absence of
screening during a median of 21.3 years. Within follow-up
periods between 10 and 12 years, the proportions of distal
CRC cases that were either early-detected or prevented among
screening users ranged between $67\%$ $(95\%$ CI $61-72\%)$
in the PLCO and $80\%$ $(95\%$ CI $68-89\%)$ in the SCORE
trial, with approximately equal shares of early-detected and
prevented cases in the SCORE and the PLCO trials, and a
higher share of prevented cases in the UKFSST.A single
screening sigmoidoscopy prevents two out of three incident
cancers in the distal colon and rectum over a period of more
than 20 years, on top of early-detecting prevalent cases at
screening.},
cin = {M320 / C060 / C070},
ddc = {610},
cid = {I:(DE-He78)M320-20160331 / I:(DE-He78)C060-20160331 /
I:(DE-He78)C070-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41165595},
doi = {10.1093/jnci/djaf313},
url = {https://inrepo02.dkfz.de/record/305585},
}