%0 Journal Article
%A Chen, Hong-Da
%A Lu, Bin
%A Shi, Ju-Fang
%A Zhou, Yue-Yang
%A Du, Ling-Bin
%A Liao, Xian-Zhen
%A Wei, Dong-Hua
%A Dong, Dong
%A Gao, Yi
%A Zhu, Chen
%A Ying, Rong-Biao
%A Zheng, Wei-Fang
%A Yan, Shi-Peng
%A Xiao, Hai-Fan
%A Zhang, Juan
%A Kong, Yun-Xin
%A Li, Fu-Rong
%A Li, Na
%A Luo, Jia-Hui
%A Luo, Chen-Yu
%A Brenner, Hermann
%A Dai, Min
%T Effectiveness and cost-effectiveness of risk-adapted colorectal cancer screening: a randomized controlled trial and modeling analysis.
%J Military medical research
%V 12
%N 1
%@ 2095-7467
%C London
%I BioMed Central
%M DKFZ-2025-02610
%P 82
%D 2025
%X Risk-adapted colorectal cancer (CRC) screening has the potential to balance effectiveness with resource demands, yet evidence comparing it with established methods remains limited. This study aims to compare outcomes of risk-adapted CRC screening with colonoscopy and fecal immunochemical test (FIT) strategies.We adopted a hybrid methodology combining real-world data from a population-based CRC screening randomized controlled trial (TARGET-C) with projections from a validated Markov-based microsimulation model (MIMIC-CRC). The TARGET-C trial enrolled 19,582 participants aged 50-74 years from 6 centers in China, randomized in a 1:2:2 ratio into 3 groups. After applying the exclusion criteria, the final analysis included 3883 participants in the one-time colonoscopy group, 7793 in the annual FIT group, and 7697 in the risk-adapted screening group. In the latter group, screening allocation was determined by a composite risk score incorporating age, sex, family history of CRC, smoking status, and body mass index, with high-risk participants referred for colonoscopy and low-risk participants for FIT. The primary outcome was detection rates of advanced neoplasm (CRC and advanced adenoma) over 4 rounds. Secondary outcomes included screening participation, colonoscopy demand, and costs from a societal perspective. Long-term effectiveness and cost-effectiveness were modeled over 15 years using MIMIC-CRC.Across 4 rounds, overall participation rates (attending at least one screening round) were 42.3
%K Humans
%K Colorectal Neoplasms: diagnosis
%K Colorectal Neoplasms: economics
%K Colorectal Neoplasms: epidemiology
%K Middle Aged
%K Cost-Benefit Analysis: methods
%K Cost-Benefit Analysis: statistics & numerical data
%K Female
%K Male
%K Aged
%K Early Detection of Cancer: methods
%K Early Detection of Cancer: economics
%K Early Detection of Cancer: standards
%K Early Detection of Cancer: statistics & numerical data
%K China: epidemiology
%K Colonoscopy: methods
%K Colonoscopy: statistics & numerical data
%K Colonoscopy: economics
%K Mass Screening: methods
%K Mass Screening: economics
%K Mass Screening: standards
%K Mass Screening: statistics & numerical data
%K Markov Chains
%K Occult Blood
%K Risk Assessment: methods
%K Colorectal cancer (CRC) (Other)
%K Cost-effectiveness (Other)
%K Randomized controlled trial (Other)
%K Risk-adapted screening (Other)
%K Screening (Other)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:41287073
%R 10.1186/s40779-025-00671-7
%U https://inrepo02.dkfz.de/record/306545