Table 1.

Screening Test Characteristics Used in the Analysis

Screening test/test characteristic	Value	Source
FIT (per person)		Lin et al,2 2021
Specificity	0.97
$\begin{array}{l}\text{Sensitivity for adenomas }1\text{ to}<6\text{ mm}\hfill \\ \text{Sensitivity for adenomas }6\text{ to}<10\text{ mm}\hfill \end{array}\}$	0.07a
Sensitivity for adenomas ≥10 mm	0.22b
Sensitivity for colorectal cancer	0.74
sDNA-FIT (per person)		Lin et al,2 2021
Specificity	0.91
$\begin{array}{l}\text{Sensitivity for adenomas }1\text{ to}<6\text{ mm}\hfill \\ \text{Sensitivity for adenomas }6\text{ to}<10\text{ mm}\hfill \end{array}\}$	0.15a
Sensitivity for adenomas ≥10 mm	0.42b
Sensitivity for colorectal cancer	0.94
Colonoscopy (within reach, per lesion)c
Specificity	0.86d	Schroy et al,15 2013
Sensitivity for adenomas 1 to <6 mm	0.75	van Rijn et al,16 2006
Sensitivity for adenomas 6 to <10 mm	0.85	van Rijn et al,16 2006
Sensitivity for adenomas ≥10 mm	0.95	van Rijn et al,16 2006
Sensitivity for colorectal cancer	0.95	By assumptione
SIG (within reach, per lesion)
Specificity	0.87d	Weissfeld et al,17 2005
Sensitivity for adenomas 1 to <6 mm	0.75	By assumptionf
Sensitivity for adenomas 6 to <10 mm	0.85	By assumptionf
Sensitivity for adenomas ≥10 mm	0.95	By assumptionf
Sensitivity for colorectal cancer	0.95	By assumptionf
CTC (per lesion)		Johnson et al,18 2008
Specificity	0.88g
Sensitivity for adenomas 1 to <6 mm	NR
Sensitivity for adenomas 6 to <10 mm	0.57
Sensitivity for adenomas ≥10 mm	0.84
Sensitivity for colorectal cancer	0.84e

Abbreviations: CTC, computed tomography colonography; FIT, fecal immunochemical test (with positivity cutoff of 20 μg of hemoglobin per gram of feces); NR, not reported (adenoma size < 6 mm [the threshold size for referral to colonoscopy]); sDNA-FIT, multitarget stool DNA test with a fecal immunochemical assay; SIG, flexible sigmoidoscopy.

^aFor persons with nonadvanced adenomas. For persons with adenomas 1 mm to <6 mm, sensitivity was assumed to equal the positivity rate in persons without adenomas. Sensitivity for persons with adenomas 6 mm to <10 mm was chosen such that the weighted mean sensitivity for persons with adenomas 1 mm to <6 mm and 6 mm to <10 mm was equal to the sensitivity for nonadvanced adenomas.

^bFor persons with advanced adenomas (ie, adenomas ≥10 mm, adenomas with advanced histology, or both); the studies in the meta-analysis in Lin et al² did not provide sensitivity for adenomas ≥10 mm separately from advanced adenomas.

^cThe same test characteristics were assumed to apply to all colonoscopies, regardless of indication. No correlation in findings at CTC or SIG and follow-up colonoscopy was assumed.

^dThe lack of specificity with endoscopy reflects detection of nonadenomatous polyps, which, in the case of sigmoidoscopy, may lead to unnecessary follow-up colonoscopy, and in the case of colonoscopy, leads to unnecessary polypectomy, which is associated with an increased risk of complications.

^eSensitivity for cancer was assumed to be the same as sensitivity for adenomas ≥10 mm because of the small number of cancers detected in screening studies.

^fSensitivity for flexible sigmoidoscopy was assumed to equal that of colonoscopy within reach of the sigmoidoscope and 0 for lesions beyond reach of the scope.

^gThe lack of specificity with CTC reflects detection of nonadenomatous lesions ≥6 mm, artifacts, stool, and adenomas smaller than the 6-mm threshold for colonoscopy referral that are measured as ≥6 mm.