Evidence map›Paper›PMID 41027593›Full record

ArticleJournal of the National Cancer Institute2025

Evaluating benefit-to-burden ratios of the established and emerging colorectal cancer screening strategies.

Derek W Ebner, A Mark Fendrick, John B Kisiel, Chris Estes, Vahab Vahdat, A Burak Ozbay, Paul J Limburg

Abstract read
In one paragraph

Article in Journal of the National Cancer Institute, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Derek W EbnerDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States.ORCID 0000-0003-0089-2507
A Mark FendrickDepartment of Internal Medicine, University of Michigan, Ann Arbor, MI, United States.ORCID 0000-0002-7734-6742
John B KisielDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States.ORCID 0000-0002-3840-5324
Chris EstesExact Sciences Corporation, Madison, WI, United States.ORCID 0000-0002-2367-6535
Vahab VahdatExact Sciences Corporation, Madison, WI, United States.ORCID 0000-0001-7831-7567
A Burak OzbayExact Sciences Corporation, Madison, WI, United States.ORCID 0000-0002-8624-6313
Paul J LimburgExact Sciences Corporation, Madison, WI, United States.ORCID 0000-0002-2428-5675

Funding

Exact Sciences Corporation
6 · The paper itself

Abstract

backgroundRecommended noninvasive strategies for average-risk colorectal cancer (CRC) screening include multitarget stool DNA and fecal immunochemical test from ages 45 to 75 years. With new clinical trials, performance data for next-generation multitarget stool DNA, multitarget stool RNA, and blood-based screening tests are now available. This decision analytical model study evaluated the estimated benefit-to-burden ratio by means of efficient frontiers for noninvasive established and emerging CRC screening strategies.

methodsOutcomes were estimated using the Colorectal Cancer and Adenoma Incidence and Mortality microsimulation model for average-risk individuals in the United States. Screening strategies were next-generation multitarget stool DNA (an updated marker panel), fecal immunochemical tests, multitarget stool RNA, or blood-based tests every 1-3 years, over various age ranges. Test performance inputs were derived from recent large clinical trials. A strategy was deemed efficient if no other strategy provided more life-years gained with equivalent or fewer lifetime colonoscopies and near-efficient if within 3 days of life-years gained of the efficient frontier.

resultsAll modeled screening strategies resulted in life-years gained vs no screening. No strategy using blood-based tests was efficient or near-efficient. Overall, 10 strategies were efficient (6 next-generation multitarget stool DNA and 4 fecal immunochemical tests), including 2 strategies among those ages 45-75 years (biennial and triennial next-generation multitarget stool DNA). Overall, 22 strategies were near-efficient, including 4 strategies among those ages 45-75 years (annual, biennial, or triennial fecal immunochemical test; annual next-generation multitarget stool DNA).

conclusionBased on this modeling study, next-generation multitarget stool DNA was the only noninvasive screening test at guideline-endorsed interval and age-recommended ranges that was deemed efficient. Blood-based and multitarget stool RNA strategies were deemed not efficient for primary screening.

Indexed as

Colorectal NeoplasmsEarly Detection of CancerMass ScreeningAdenomaAgedBiomarkers, TumorColonoscopyDecision Support TechniquesFecesFemaleHumansIncidenceMaleMiddle AgedOccult BloodUnited StatesBiomarkers, Tumor

Identifiers

PMID41027593
PMCPMC12682382

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.