{
  "abstract": "Background Pragmatic colorectal cancer (CRC) screening trials compare colonoscopy with faecal immunochemical testing (FIT), but differences in adherence complicate interpretation of comparative outcomes.Objective To compare 10-year risks of CRC mortality, CRC incidence and all-cause mortality under one-time colonoscopy versus sustained FIT strategies in the COLONPREV Trial.Design We conducted a post hoc per-protocol analysis of 17 270 screening initiators aged 50–69 years in eight Spanish regions, using inverse probability weighting to adjust for observed confounding and informative protocol deviations.Results Weighted 10-year risks were similar for CRC incidence (0.80% FIT vs 0.86% colonoscopy; risk difference (RD) 0.06%, 95% CI −0.25% to 0.37%) and all-cause mortality (4.02% vs 4.09%; RD 0.07%, 95% CI −0.76% to 0.84%). CRC mortality was lower with colonoscopy (0.072% FIT vs 0.042% colonoscopy; RD −0.03%, 95% CI −0.12% to 0.06%), but estimates were imprecise.Conclusion Sustained colonoscopy and FIT showed similar 10-year outcomes overall, highlighting the importance of adherence pathways in pragmatic screening trials.Trial registration number ClinicalTrials.gov: NCT00906997.",
  "authors": [
    {
      "affiliations": [
        "Gastroenterology, Hospital Clínic of Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), University of Barcelona, Barcelona, Spain"
      ],
      "name": "Antoni Castells"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Hospital Universitario de Canarias, Instituto Universitario de Tecnologías Biomédicas (ITB), Universidad de La Laguna, Santa Cruz de Tenerife, Spain"
      ],
      "name": "Enrique Quintero"
    },
    {
      "affiliations": [
        "Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, Switzerland"
      ],
      "name": "Hongruyu Chen"
    },
    {
      "affiliations": [
        "Department of Hepatology and Gastroenterology, Biogipuzkoa Health Research Institute - Donostia University Hospital, Universidad del País Vasco (UPV/EHU), CIBERehd, San Sebastián, Spain"
      ],
      "name": "Luis Bujanda"
    },
    {
      "affiliations": [
        "Dirección General de Salud Pública, Conselleria de Sanitat, Valencia, Spain"
      ],
      "name": "Susana Castán-Cameo"
    },
    {
      "affiliations": [
        "Gastroenterology, Complexo Hospitalario Universitario de Ourense, Grupo de Investigación en Oncología Digestiva-Ourense, CIBERehd, Ourense, Spain"
      ],
      "name": "Joaquín Cubiella"
    },
    {
      "affiliations": [
        "Gastroenterology, Hospital Universitario 12 de Octubre, Madrid, Spain"
      ],
      "name": "José Díaz-Tasende"
    },
    {
      "affiliations": [
        "Gastroenterology, University of Zaragoza, IIS Aragón, CIBERehd, Zaragoza, Spain"
      ],
      "name": "Ángel Lanas"
    },
    {
      "affiliations": [
        "Gastroenterology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain"
      ],
      "name": "Akiko Ono"
    },
    {
      "affiliations": [
        "Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, Switzerland"
      ],
      "name": "Miquel Serra-Burriel"
    },
    {
      "affiliations": [],
      "name": "COLONPREV Study Investigators"
    }
  ],
  "title": "Colonoscopy versus biennial FIT screening: a post hoc sustained-strategy analysis of the COLONPREV Trial",
  "uid": "ebb0526a-3128-5b44-bd41-7d2fccd74c71"
}