Related Experiment Video
Updated: Jun 12, 2026
E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Colonoscopy versus biennial FIT screening: a post hoc sustained-strategy analysis of the COLONPREV Trial
Antoni Castells1, Enrique Quintero2, Hongruyu Chen3
1Gastroenterology, Hospital Clínic of Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), University of Barcelona, Barcelona, Spain.
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.
Related Concept Videos
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and solid...
01:25Endoscopic Procedures II: Colonoscopy
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...