ArticleBMJ open2022
Optimising colorectal cancer screening in Shanghai, China: a modelling study.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- One- versus two-sample fecal immunochemical testing for colorectal cancer screening: a systematic review and meta-analysis of participation, diagnostic performance, and cost-effectiveness.BMC gastroenterology · 2026Pooled it
- Diagnostic sensitivity and specificity of enhanced computed tomography in colorectal tumors: a meta-analysis and systematic review.Diagnostic and interventional radiology (Ankara, Turkey) · 2026Pooled it
- The efficacy of colorectal cancer screening: a systematic review and meta-analysis.Preventive medicine reports · 2026Review
- Systemic inflammatory biomarkers (NLR, SII, PNI and FPR) combined with CEA for predicting advanced colorectal neoplasms: development and temporal validation of a machine learning model.Frontiers in oncology · 2026Article
- The impact of adherence on colorectal cancer screening cost-effectiveness: A modeling study.PLoS medicine · 2025Article
- Cost-effectiveness of colorectal cancer screening under different scenarios of colonoscopy adherence: a microsimulation study.BMJ public health · 2025Article
- Efficient organized colorectal cancer screening in Shenzhen: a microsimulation modelling study.BMC public health · 2024Article
- A qualitative interview study on colorectal cancer screening in China.Frontiers in medicine · 2024Article
- The geriatric Asia-Pacific oncology nursing imperative.Asia-Pacific journal of oncology nursing · 2023Article
- Review
- The NCC mathematical modeling framework for decision-making of six major cancers.Journal of the National Cancer Center · 2023Article
- Cost-effectiveness analysis of colorectal cancer screening in Shanghai, China: A modelling study.Preventive medicine reports · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
introductionTo reduce the burden of colorectal cancer (CRC) in Shanghai, China, a CRC screening programme was commenced in 2013 inviting those aged 50-74 years to triennial screening with a faecal immunochemical test (FIT) and risk assessment. However, it is unknown whether this is the optimal screening strategy for this population. We aimed to determine the optimal CRC screening programme for Shanghai in terms of benefits, burden, harms and cost-effectiveness.
methodsUsing Microsimulation Screening Analysis-Colon (MISCAN-Colon), we estimated the costs and effects of the current screening programme compared with a situation without screening. Subsequently, we estimated the benefits (life years gained (LYG)), burden (number of screening events, colonoscopies and false-positive tests), harms (number of colonoscopy complications) and costs (Renminb (¥)) of screening for 324 alternative screening strategies. We compared several different age ranges, screening modalities, intervals and FIT cut-off levels. An incremental cost-effectiveness analysis determined the optimal strategy assuming a willingness-to-pay of ¥193 931 per LYG.
resultsCompared with no screening, the current screening programme reduced CRC incidence by 40% (19 cases per 1000 screened individuals) and CRC mortality by 67% (7 deaths). This strategy gained 32 additional life years, increased colonoscopy demand to 1434 per 1000 individuals and cost an additional ¥199 652. The optimal screening strategy was annual testing using a validated one-sample FIT, with a cut-off of 10 µg haemoglobin per gram from ages 45 to 80 years (incremental cost-effectiveness ratio, ¥62 107). This strategy increased LY by 0.18% and costs by 27%. Several alternative cost-effective strategies using a validated FIT offered comparable benefits to the current programme but lower burden and costs.
conclusionsAlthough the current screening programme in Shanghai is effective at reducing CRC incidence and mortality, the programme could be optimised using a validated FIT. When implementing CRC screening, jurisdictions with limited health resources should use a validated test.
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