Preventive medicine is an effective strategy to reduce cancer risk, and early detection has a key role in improving patient outcomes. The success of public health campaigns largely depends on the accessibility of healthcare services and the active engagement of individuals who are at average risk. Colorectal cancer (CRC) is a commonly diagnosed malignancy worldwide and represents a major contributor to global cancer-related mortality. Screening strategies for CRC mainly consist of stool tests and more invasive structural examinations such as colonoscopy, which can dissuade individuals from complying with the recommended programs. In a recent article in the The Lancet, Castells et al. present the results of the COLONPREV trial (NCT00906997), reporting that fecal immunochemical testing (FIT) was non-inferior to colonoscopy screening for CRC-related mortality at 10 years.
The COLONPREV study was a multicenter, pragmatic, randomized, controlled trial conducted between 2009 and 2021 across 15 tertiary hospitals in Spain, designed to assess whether invitation to FIT is non-inferior to colonoscopy in CRC screening, regarding CRC-related mortality at 10 years. A total of 57,404 presumptively healthy individuals aged 50–69 years were randomly assigned (1:1) and invited to participate in either biennial FIT or a one-time colonoscopy. The intention-to-screen population included 26,719 and 26,332 individuals in the FIT and colonoscopy groups, respectively. The participation rate was higher in the FIT group than the colonoscopy group (39.9% versus 31.8%), indicating greater acceptability of the non-invasive screening modality, as also reflected by the final number of participants undergoing FIT (n = 13,599) and colonoscopy (n = 5,419).
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