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Comparative Evaluation of Participation and Diagnostic Yield of Colonoscopy vs Fecal Immunochemical Test vs Risk-Adapted Screening in Colorectal Cancer Screening: Interim Analysis of a Multicenter Randomized Controlled Trial (TARGET-C) | |
Chen, Hongda1; Lu, Ming1; Liu, Chengcheng1; Zou, Shuangmei2; Du, Lingbin3; Liao, Xianzhen4; Dong, Dong5; Wei, Donghua6; Gao, Yi7; Zhu, Chen3; Zhu, Liming8; Zheng, Weifang9; Xiao, Haifan4; Kong, Yunxin5; Yin, Huiping6; Zhou, Hai10; Ying, Rongbiao11; Wang, Baoquan12; Zhang, Juan6; Zhang, Xiaopeng13; Zhang, Qiang14; Zhang, Xuan7; Zhang, Yuhan1; Wang, Hong1; Guo, Lanwei1,15; Liu, Li16,17; Ren, Jiansong1; Shi, Jufang1; Li, Ni1; Miao, Xiaoping16,17; Brenner, Hermann18,19,20,21; Dai, Min1 | |
2020-08-01 | |
发表期刊 | AMERICAN JOURNAL OF GASTROENTEROLOGY |
ISSN | 0002-9270 |
通讯作者 | Dai, Min(daimin2002@hotmail.com) |
摘要 | INTRODUCTION: In colorectal cancer screening, implementing risk-adapted screening might be more effective than traditional screening strategies. We aimed to compare the effectiveness of a risk-adapted screening strategy with colonoscopy and fecal immunochemical test (FIT) in colorectal cancer screening. METHODS: A randomized controlled trial was conducted in 6 centers in China since May 2018. Nineteen thousand five hundred forty-six eligible participants aged 50-74 years were recruited and randomly allocated into 1 of the 3 screening groups in a 1:2:2 ratio: (i) one-time colonoscopy (n=3,916), (ii) annual FIT (n=7,854), and (iii) annual risk-adapted screening (n=7,776). Based on the risk-stratification score, high-risk subjects were referred for colonoscopy and low-risk ones were referred for FIT. All subjects with positive FIT were referred for diagnostic colonoscopy. The detection rate of advanced neoplasm was the primary outcome. The study is registered with the China Clinical Trial Registry (www.chictr.org.cn Identifier: ChiCTR1800015506). RESULTS: For baseline screening, the participation rates of the colonoscopy, FIT, and risk-adapted screening groups were 42.5% (1,665/3,916), 94.0%(7,386/7,854), and 85.2%(6,628/7,776), respectively. For the intention-to-screen analysis, the detection rates of advanced neoplasm were 2.40%(94/3,916), 1.13%(89/7,854), and 1.66%(129/7,776), with odds ratios (95% confidence intervals) of 2.16 (1.61-2.90; P < 0.001) for colonoscopy vs FIT, 1.45 (1.10-1.90; P < 0.001) for colonoscopy vs risk-adapted screening, and 1.49 (1.13-1.97; P < 0.001) for risk-adapted screening vs FIT, respectively. The numbers of subjects who required a colonoscopic examination to detect 1 advanced neoplasm were 18 in the colonoscopy group, 10 in the FIT group, and 11 in the risk-adapted screening group. DISCUSSION: For baseline screening, the risk-adapted screening approach showed a high participation rate, and its diagnostic yield was superior to that of FIT at a similarly low load of colonoscopy. |
DOI | 10.14309/ajg.0000000000000624 |
收录类别 | SCI |
语种 | 英语 |
资助项目 | CAMS Innovation Fund for Medical Sciences[2017-I2M-1-006] ; CAMS Innovation Fund for Medical Sciences[2019-I2M-2-002] ; National Natural Science Foundation of China[81703309] ; National Key Research and Development Plan Program[2016YFC1302702] ; National Key Research and Development Plan Program[2018YFC1315000] |
项目资助者 | CAMS Innovation Fund for Medical Sciences ; National Natural Science Foundation of China ; National Key Research and Development Plan Program |
WOS研究方向 | Gastroenterology & Hepatology |
WOS类目 | Gastroenterology & Hepatology |
WOS记录号 | WOS:000619500100023 |
出版者 | LIPPINCOTT WILLIAMS & WILKINS |
引用统计 | |
文献类型 | 期刊论文 |
条目标识符 | http://ir.hfcas.ac.cn:8080/handle/334002/119636 |
专题 | 中国科学院合肥物质科学研究院 |
通讯作者 | Dai, Min |
作者单位 | 1.Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Off Canc Screening, Natl Clin Res Ctr Canc,Canc Hosp, Beijing, Peoples R China 2.Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Dept Pathol, Natl Clin Res Ctr Canc,Canc Hosp, Beijing, Peoples R China 3.Chinese Acad Sci, Inst Canc & Basic Med ICBM, Dept Canc Prevent, Canc Hosp,Univ Chinese Acad Sci,Zhejiang Canc Hos, Beijing, Peoples R China 4.Hunan Canc Hosp, Dept Canc Prevent, Changsha, Peoples R China 5.Xuzhou Canc Hosp, Off Canc Prevent & Treatment, Xuzhou, Jiangsu, Peoples R China 6.Anhui Prov Canc Hosp, Dept Canc Prevent, Hefei, Peoples R China 7.Kunming Med Univ, Dept Colorectal Surg, Tumor Hosp Yunnan Prov, Affiliated Hosp 3, Kunming, Yunnan, Peoples R China 8.Chinese Acad Sci, Inst Canc & Basic Med ICBM, Dept Med Oncol, Canc Hosp,Univ Chinese Acad Sci,Zhejiang Canc Hos, Beijing, Peoples R China 9.Lanxi Red Cross Hosp, Dept Proctol, Jinhua, Zhejiang, Peoples R China 10.Kunming Med Univ, Adm Management Off Yunan Canc Ctr, Yunnan Canc Ctr, Yunnan Canc Hosp,Affiliated Hosp 3, Kunming, Yunnan, Peoples R China 11.Taizhou Canc Hosp, Dept Surg Oncol, Taizhou, Peoples R China 12.Lanxi Red Cross Hosp, Dept Publ Hlth, Jinhua, Zhejiang, Peoples R China 13.Hefei Ctr Dis Control & Prevent, Dept NCD Prevent & Heath Educ, Hefei, Peoples R China 14.Kunming Med Univ, Dept Canc Prevent, Affiliated Hosp 3, Tumor Hosp Yunnan Prov, Kunming, Yunnan, Peoples R China 15.Zhengzhou Univ, Henan Canc Hosp, Henan Off Canc Control & Res, Affiliated Canc Hosp, Zhengzhou, Peoples R China 16.Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth, Dept Epidemiol & Biostat, Wuhan, Peoples R China 17.Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth, Minist Educ,Key Lab Environm Hlth, Wuhan, Peoples R China 18.German Canc Res Ctr, Div Clin Epidemiol & Aging Res, Heidelberg, Germany 19.German Canc Res Ctr, Div Prevent Oncol, Heidelberg, Germany 20.Natl Ctr Tumor Dis NCT, Heidelberg, Germany 21.German Canc Res Ctr, German Canc Consortium DKTK, Heidelberg, Germany |
推荐引用方式 GB/T 7714 | Chen, Hongda,Lu, Ming,Liu, Chengcheng,et al. Comparative Evaluation of Participation and Diagnostic Yield of Colonoscopy vs Fecal Immunochemical Test vs Risk-Adapted Screening in Colorectal Cancer Screening: Interim Analysis of a Multicenter Randomized Controlled Trial (TARGET-C)[J]. AMERICAN JOURNAL OF GASTROENTEROLOGY,2020,115. |
APA | Chen, Hongda.,Lu, Ming.,Liu, Chengcheng.,Zou, Shuangmei.,Du, Lingbin.,...&Dai, Min.(2020).Comparative Evaluation of Participation and Diagnostic Yield of Colonoscopy vs Fecal Immunochemical Test vs Risk-Adapted Screening in Colorectal Cancer Screening: Interim Analysis of a Multicenter Randomized Controlled Trial (TARGET-C).AMERICAN JOURNAL OF GASTROENTEROLOGY,115. |
MLA | Chen, Hongda,et al."Comparative Evaluation of Participation and Diagnostic Yield of Colonoscopy vs Fecal Immunochemical Test vs Risk-Adapted Screening in Colorectal Cancer Screening: Interim Analysis of a Multicenter Randomized Controlled Trial (TARGET-C)".AMERICAN JOURNAL OF GASTROENTEROLOGY 115(2020). |
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