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Background (2) annual fecal immunochemical test (FIT) (n = 7793) ; (3) annual risk-adapted screening (n = 7697), in which, based on the risk-stratification score, high-risk participants were referred for colonoscopy and low-risk ones were referred for FIT. Three consecutive screening rounds were conducted for both the FIT and the risk-adapted screening arms. Follow-up to trace the health outcome for all the participants was conducted over the 3-year study period. The detection rate of advanced colorectal neoplasia (CRC and advanced precancerous lesions) was the main outcome. The trial was registered in the Chinese Clinical Trial Registry (number: ChiCTR1800015506). Results In the colonoscopy, FIT, and risk-adapted screening arms over 3 screening rounds, the participation rates were 42. 4%, 99. 3%, and 89. 2%, respectively; the detection rates for advanced neoplasm (intention-to-treat analysis) were 2. 76%, 2. 17%, and 2. 35%, respectively, with an odds ratio (OR) colonoscopy vs FIT of 1. 27 (95% confidence interval CI: 0. 99–1. 63; P =. 056), an OR colonoscopy vs risk-adapted screening of 1. 17 (95% CI, 0. 91–1. 49; P =. 218), and an OR risk-adapted screening vs FIT of 1. 09 (95% CI, 0. 88–1. 35; P =. 438) ; the numbers of colonoscopies needed to detect 1 advanced neoplasm were 15. 4, 7. 8, and 10. 2, respectively; the costs for detecting 1 advanced neoplasm from a government perspective using package payment format were 6928 Chinese Yuan (CNY) (1004), 5821 CNY (844), and 6694 CNY (970), respectively. Conclusions The risk-adapted approach is a feasible and cost-favorable strategy for population-based CRC screening and therefore could complement the well-established one-time colonoscopy and annual repeated FIT screening strategies. (Chinese Clinical Trial Registry; ChiCTR1800015506).
Chen et al. (Thu,) studied this question.