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Long-Term Colorectal Cancer Incidence After Adenoma and Serrated Polyp Removal: Results From the Colonprev Trial.

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Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
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Programmatic screening for colorectal cancer: the COLONPREV study.

Antoni Castells1, Enrique Quintero

  • 1Department of Gastroenterology, Hospital Clínic, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), IDIBAPS, University of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain, castells@clinic.cat.

Digestive Diseases and Sciences
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PubMed
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The COLONPREV trial compares once-only colonoscopy versus biennial fecal immunochemical testing for colorectal cancer screening. This study aims to reduce cancer mortality and identify cost-effective population-based strategies.

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Area of Science:

  • Gastroenterology
  • Preventive Medicine
  • Oncology

Background:

  • Colorectal cancer (CRC) remains a significant public health concern.
  • Effective screening strategies are crucial for early detection and mortality reduction.
  • Population-based screening programs require evidence-based, cost-effective approaches.

Purpose of the Study:

  • To evaluate the 10-year efficacy of once-only colonoscopy versus biennial fecal immunochemical testing (FIT) in reducing CRC-related mortality.
  • To determine the most cost-effective strategy for population-based colorectal cancer screening.
  • To clarify controversial issues regarding different colorectal cancer screening strategies using the COLONPREV dataset.

Main Methods:

  • A pragmatic, multicenter, nationwide, randomized controlled trial (COLONPREV study).
  • Comparison of once-only colonoscopy with biennial fecal immunochemical testing in an average-risk population.
  • Analysis of data from the first screening round and nested evaluations.

Main Results:

  • The first screening round results are reported.
  • Nested evaluations provide insights into controversial screening strategy issues.
  • Data collection is ongoing to assess 10-year CRC-related mortality reduction.

Conclusions:

  • The COLONPREV study will provide crucial evidence on the comparative effectiveness and cost-effectiveness of two primary colorectal cancer screening strategies.
  • Findings may inform national guidelines for programmatic, population-based screening.
  • The study addresses key controversies in optimizing colorectal cancer screening protocols.