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dc.contributor.authorBretthauer, Michael
dc.contributor.authorLøberg, Magnus
dc.contributor.authorWieszczy, Paulina
dc.contributor.authorKalager, Mette
dc.contributor.authorEmilsson, Louise
dc.contributor.authorGarborg, Kjetil Kjeldstad
dc.contributor.authorRupinski, Maciej
dc.contributor.authorDekker, Evelien
dc.contributor.authorSpaander, Manon
dc.contributor.authorBugajski, Marek
dc.contributor.authorHolme, Øyvind
dc.contributor.authorZauber, Ann G.
dc.contributor.authorPilonis, Nastazja D.
dc.contributor.authorMróz, Andrzej
dc.contributor.authorKuipers, Ernst J.
dc.contributor.authorShi, Joy
dc.contributor.authorHernán, Miguel A.
dc.contributor.authorAdami, Hans Olov
dc.contributor.authorRegula, Jaroslaw
dc.contributor.authorHoff, Geir
dc.contributor.authorKamiński, Michał Filip
dc.date.accessioned2023-03-22T09:33:47Z
dc.date.available2023-03-22T09:33:47Z
dc.date.issued2022-10-27
dc.description.abstract<p><i>Background:</i> Although colonoscopy is widely used as a screening test to detect colorectal cancer, its effect on the risks of colorectal cancer and related death is unclear. <p><i>Methods:</i> We performed a pragmatic, randomized trial involving presumptively healthy men and women 55 to 64 years of age drawn from population registries in Poland, Norway, Sweden, and the Netherlands between 2009 and 2014. The participants were randomly assigned in a 1:2 ratio to either receive an invitation to undergo a single screening colonoscopy (the invited group) or to receive no invitation or screening (the usual-care group). The primary end points were the risks of colorectal cancer and related death, and the secondary end point was death from any cause. <p><i>Results:</i> Follow-up data were available for 84,585 participants in Poland, Norway, and Sweden - 28,220 in the invited group, 11,843 of whom (42.0%) underwent screening, and 56,365 in the usual-care group. A total of 15 participants had major bleeding after polyp removal. No perforations or screening-related deaths occurred within 30 days after colonoscopy. During a median follow-up of 10 years, 259 cases of colorectal cancer were diagnosed in the invited group as compared with 622 cases in the usual-care group. In intention-to-screen analyses, the risk of colorectal cancer at 10 years was 0.98% in the invited group and 1.20% in the usual-care group, a risk reduction of 18% (risk ratio, 0.82; 95% confidence interval [CI], 0.70 to 0.93). The risk of death from colorectal cancer was 0.28% in the invited group and 0.31% in the usual-care group (risk ratio, 0.90; 95% CI, 0.64 to 1.16). The number needed to invite to undergo screening to prevent one case of colorectal cancer was 455 (95% CI, 270 to 1429). The risk of death from any cause was 11.03% in the invited group and 11.04% in the usual-care group (risk ratio, 0.99; 95% CI, 0.96 to 1.04). <p><i>Conclusions:</i> In this randomized trial, the risk of colorectal cancer at 10 years was lower among participants who were invited to undergo screening colonoscopy than among those who were assigned to no screening. <p>(Funded by the Research Council of Norway and others; NordICC ClinicalTrials.gov number, NCT00883792.).en_US
dc.identifier.citationBretthauer M, Løberg M, Wieszczy P, Kalager M, Emilsson L, Garborg KK, Rupinski M, Dekker E, Spaander M, Bugajski M, Holme Ø, Zauber AG, Pilonis ND, Mróz A, Kuipers EJ, Shi, Hernán MA, Adami HO, Regula J, Hoff G, Kamiński MF. Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death. New England Journal of Medicine. 2022;387(17):1547-1556en_US
dc.identifier.cristinIDFRIDAID 2061038
dc.identifier.doi10.1056/NEJMoa2208375
dc.identifier.issn0028-4793
dc.identifier.issn1533-4406
dc.identifier.urihttps://hdl.handle.net/10037/28810
dc.language.isoengen_US
dc.publisherMassachusetts Medical Societyen_US
dc.relation.journalNew England Journal of Medicine
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2022 The Massachusetts Medical Society.en_US
dc.titleEffect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Deathen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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