TY  - JOUR
AU  - Chen, Hong-Da
AU  - Lu, Bin
AU  - Shi, Ju-Fang
AU  - Zhou, Yue-Yang
AU  - Du, Ling-Bin
AU  - Liao, Xian-Zhen
AU  - Wei, Dong-Hua
AU  - Dong, Dong
AU  - Gao, Yi
AU  - Zhu, Chen
AU  - Ying, Rong-Biao
AU  - Zheng, Wei-Fang
AU  - Yan, Shi-Peng
AU  - Xiao, Hai-Fan
AU  - Zhang, Juan
AU  - Kong, Yun-Xin
AU  - Li, Fu-Rong
AU  - Li, Na
AU  - Luo, Jia-Hui
AU  - Luo, Chen-Yu
AU  - Brenner, Hermann
AU  - Dai, Min
TI  - Effectiveness and cost-effectiveness of risk-adapted colorectal cancer screening: a randomized controlled trial and modeling analysis.
JO  - Military medical research
VL  - 12
IS  - 1
SN  - 2095-7467
CY  - London
PB  - BioMed Central
M1  - DKFZ-2025-02610
SP  - 82
PY  - 2025
AB  - 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
KW  - Humans
KW  - Colorectal Neoplasms: diagnosis
KW  - Colorectal Neoplasms: economics
KW  - Colorectal Neoplasms: epidemiology
KW  - Middle Aged
KW  - Cost-Benefit Analysis: methods
KW  - Cost-Benefit Analysis: statistics & numerical data
KW  - Female
KW  - Male
KW  - Aged
KW  - Early Detection of Cancer: methods
KW  - Early Detection of Cancer: economics
KW  - Early Detection of Cancer: standards
KW  - Early Detection of Cancer: statistics & numerical data
KW  - China: epidemiology
KW  - Colonoscopy: methods
KW  - Colonoscopy: statistics & numerical data
KW  - Colonoscopy: economics
KW  - Mass Screening: methods
KW  - Mass Screening: economics
KW  - Mass Screening: standards
KW  - Mass Screening: statistics & numerical data
KW  - Markov Chains
KW  - Occult Blood
KW  - Risk Assessment: methods
KW  - Colorectal cancer (CRC) (Other)
KW  - Cost-effectiveness (Other)
KW  - Randomized controlled trial (Other)
KW  - Risk-adapted screening (Other)
KW  - Screening (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:41287073
DO  - DOI:10.1186/s40779-025-00671-7
UR  - https://inrepo02.dkfz.de/record/306545
ER  -