Table 1.
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.