Colonoscopy versus fecal immunochemical testing in colorectal-cancer screening
- PMID: 22356323
- DOI: 10.1056/NEJMoa1108895
Colonoscopy versus fecal immunochemical testing in colorectal-cancer screening
Erratum in
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Colonoscopy versus Fecal Immunochemical Testing in Colorectal-Cancer Screening.N Engl J Med. 2016 May 12;374(19):1898. doi: 10.1056/NEJMx150040. N Engl J Med. 2016. PMID: 27168447 No abstract available.
Abstract
Background: Colonoscopy and fecal immunochemical testing (FIT) are accepted strategies for colorectal-cancer screening in the average-risk population.
Methods: In this randomized, controlled trial involving asymptomatic adults 50 to 69 years of age, we compared one-time colonoscopy in 26,703 subjects with FIT every 2 years in 26,599 subjects. The primary outcome was the rate of death from colorectal cancer at 10 years. This interim report describes rates of participation, diagnostic findings, and occurrence of major complications at completion of the baseline screening. Study outcomes were analyzed in both intention-to-screen and as-screened populations.
Results: The rate of participation was higher in the FIT group than in the colonoscopy group (34.2% vs. 24.6%, P<0.001). Colorectal cancer was found in 30 subjects (0.1%) in the colonoscopy group and 33 subjects (0.1%) in the FIT group (odds ratio, 0.99; 95% confidence interval [CI], 0.61 to 1.64; P=0.99). Advanced adenomas were detected in 514 subjects (1.9%) in the colonoscopy group and 231 subjects (0.9%) in the FIT group (odds ratio, 2.30; 95% CI, 1.97 to 2.69; P<0.001), and nonadvanced adenomas were detected in 1109 subjects (4.2%) in the colonoscopy group and 119 subjects (0.4%) in the FIT group (odds ratio, 9.80; 95% CI, 8.10 to 11.85; P<0.001).
Conclusions: Subjects in the FIT group were more likely to participate in screening than were those in the colonoscopy group. On the baseline screening examination, the numbers of subjects in whom colorectal cancer was detected were similar in the two study groups, but more adenomas were identified in the colonoscopy group. (Funded by Instituto de Salud Carlos III and others; ClinicalTrials.gov number, NCT00906997.).
Comment in
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Colonoscopy as a triage screening test.N Engl J Med. 2012 Feb 23;366(8):759-60. doi: 10.1056/NEJMe1114639. N Engl J Med. 2012. PMID: 22356330 No abstract available.
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[Blood in the stool is equal to colonoscopy in diagnosis of colorectal carcinomas].Praxis (Bern 1994). 2012 Jun 20;101(13):875-6. doi: 10.1024/1661-8157/a000969. Praxis (Bern 1994). 2012. PMID: 22715081 German. No abstract available.
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[Colonoscopy versus fecal immunochemical testing in colorectal-cancer screening].Rev Clin Esp. 2012 Jul;212(7):407. Rev Clin Esp. 2012. PMID: 22937539 Spanish. No abstract available.
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Colonoscopia versus sangre oculta enheces en el cribado del cáncer colorrectal.Rev Clin Esp. 2012 Sep;212(8):407. Rev Clin Esp. 2012. PMID: 23115776 Spanish. No abstract available.
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[Colonoscopy versus fecal immunochemical testing in colorectal cancer screening].Z Gastroenterol. 2013 Mar;51(3):299-300. doi: 10.1055/s-0032-1330299. Epub 2013 Mar 13. Z Gastroenterol. 2013. PMID: 23487360 German. No abstract available.
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