Evidence map›Paper›PMID 42602952›Full record

ArticleBMJ public health2026

Comparative environmental impact analysis of screening tests for colorectal cancer: a single-centre life cycle assessment.

Vivek A Rudrapatna, Tzu An Wang, Parsia Vazirnia, Kaiyi Wang, Nathan Alhalel, Shadera Azzam, Gunnar Mattson, Amy Becker, Ching-Ying Oon, Shan Wang and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Vivek A RudrapatnaUniversity of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0003-1789-3004
Tzu An WangUniversity of San Francisco, San Francisco, California, USA.
Parsia VazirniaMedical College of Wisconsin, Milwaukee, Wisconsin, USA.
Kaiyi WangUniversity of California, San Francisco, California, USA.
Nathan AlhalelUniversity of California, San Francisco, California, USA.
Shadera AzzamUniversity of California, San Francisco, California, USA.
Gunnar MattsonUniversity of California, San Francisco, California, USA.
Amy BeckerUniversity of California, San Francisco, California, USA.
Ching-Ying OonUniversity of California, San Francisco, California, USA.
Shan WangDepartment of Mathematics and Statistics, University of San Francisco, San Francisco, California, USA.
William KarlonUniversity of California, San Francisco, California, USA.
Scott PasternakUniversity of California, San Francisco, California, USA.
Cassandra L ThielDepartments of Population Health and Ophthalmology, New York University Langone Health, New York, New York, USA.
Seema GandhiUniversity of California, San Francisco, California, USA.
Sean A WoolenUniversity of California, San Francisco, California, USA.

Funding

Clinical and Translational Science InstituteUL1TR001872 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COLLARD, HAROLD R, JACOBY, VANESSA · 2016 to 2025
$112.1M
UCSF Environmental Research and Translation for Health Center (EaRTH Center)P30ES030284 · NIEHS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Tracey J. Woodruff · 2020 to 2026
$11.2M
A data science framework for transforming electronic health records into real-world evidenceR00LM014099 · NLM · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Vivek Ashok Rudrapatna · 2025 to 2026
$498k
A data science framework for transforming electronic health records into real-world evidenceK99LM014099 · NLM · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI RUDRAPATNA, VIVEK ASHOK · 2023 to 2024
$178k
NCATS NIH HHS UL1 TR001872NIEHS NIH HHS P30 ES030284NLM NIH HHS K99 LM014099NLM NIH HHS R00 LM014099
6 · The paper itself

Abstract

Background: Healthcare is a major contributor to greenhouse gases. One of the most widely used healthcare services in the USA is colorectal cancer (CRC) screening, indicated for 134 million adults. Recommended screening includes annual faecal immunochemical tests (FITs), CT colonographies every 5 years or colonoscopies every 10 years. Objective: To compare the environmental impacts of these tests for CRC screening. Design: We conducted a comparative life cycle assessment of three CRC screening strategies at UCSF. We performed on-site audits to document the resources used for each screening test. We estimated the environmental impacts of these procedures, measured by global warming potential (GWP) and damage to human health. We computed 10-year impacts of each screening strategy using a Markov model. We accounted for uncertainty using hierarchical Monte Carlo simulations. Results: FITs had the lowest environmental impacts, roughly 20 percentage points superior to colonoscopies, and this was robust on sensitivity analyses. Across tests, the biggest cause of environmental harm was car-based transportation of patients and staff. Prioritising FITs over colonoscopies in the USA could enhance population health by 5.2 million disability-adjusted life-years per decade. Transitioning to electric vehicles could reduce the GWP of all screening tests by 15%-20%. Conclusions: Given the similar efficacy and safety of these tests, payors should probably prioritise FITs for low-risk patients. Governments should decarbonise transportation and mandate environmental product declarations. We call for a closer look at resource-intensive preventative health strategies, which could result in more harm than good if applied to a low-risk population.

Indexed as

Data CollectionEnvironmental MedicineMass Screening

Identifiers

PMID42602952
PMCPMC13475567

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.