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. 2019 Jun 7;25(21):2565–2580. doi: 10.3748/wjg.v25.i21.2565

Table 1.

Model-estimated benefits and burden of colorectal cancer screening starting at age 45 vs 50 per 1000 screened over a lifetime[27]

Screening test Age of start and stop Life years gained Number of colonoscopies Recommendable?
Colonoscopy every 10 yr 45-75 429 5646 Yes
50-75 404 4836 No
CTC every 5 yr 45-75 390 2666 Yes
50-75 368 2430 No
Flexible sigmoidoscopy every 5 yr 45-75 403 3761 Yes
50-75 380 3426 No
FIT every year 45-75 403 2698 Yes
50-75 377 2402 No
HSgFOBT every year 45-75 403 3364 No
50-75 377 2956 No
mt-sDNA every 3 yr 45-75 376 2640 No
50-75 350 2331 No

The model predicted better suitability for fecal immunochemical testing over high sensitivity guaiac fecal occult blood testing (HSgFOBT) because the latter has higher false positive rates (nonsteroidal anti-inflammatory drugs causing upper gastrointestinal bleeding, red meat, dietary peroxidases contained in fruits and vegetables). Thus, it increases the number of unnecessary colonoscopies. However, HSgFOBT is less expensive, making it an attractive option in low-resource settings. Colonoscopy every 10 years from the age of 45 to 75 years provides the greatest reduction of mortality and incidence, as well as more life-years gained and deaths averted, with twice as many colonoscopies as stool-based tests. CTC: Computed tomography colonoscopy; FIT: Fecal immunochemical testing; HSgFOBT: High sensitivity guaiac fecal occult blood testing; mt-sDNA: Multitarget stool DNA.