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There are several strategies for colorectal cancer (CRC) screening in the opportunistic setting (NEJM JW Gastroenterol Aug 2017 and Am J Gastroenterol 2017; 112:1016). Risk-stratified approaches use CRC risk factors to guide patients to colonoscopy or less-invasive options according to predicted neoplasia risk. Several scoring systems are available but are not widely used, and the effectiveness of risk-based screening is not known.
To address this knowledge gap, investigators initiated a multicenter, randomized, controlled trial (RCT) in China comparing colonoscopy, fecal immunochemical testing (FIT), and risk-stratified screening using the Asia Pacific Colorectal Screening (APCS) score. APCS includes five risk factors for CRC: age, sex, fam…