Title: Evaluation of the “Burgenland PREvention trial of colorectal cancer Disease with
ImmunologiCal Testing” (B-PREDICT) - a population-based colorectal cancer screening
program
Version: 2 Date: 22 Feb 2024
Reviewer's report:
The paper  Evaluation of the Burgenland PREvention trial of colorectal cancer Disease
with ImmunologiCal Testing” (B-PREDICT) - a population-based colorectal cancer screening
program by Bresina et al, compares the results (in terms of effectiveness  and efficiency) of
an organized Programme based on annual FIT testing from 40 to 80 as compared  with the
opportunistic screening colonoscopy (OPP-COL).
The issue is crucial  in order to choice the best colorectal screening policy and the results are
worth of interest although based on an observational study.
The way of reporting the results is different from how it is commonly done and sometimes
incomplete.
To my opinion , some clarification and some new analyses (if possible) would improve the
quality of the paper.
Mayor points:
1) The paper shows as an organized screening program (B-PREDICT9) is superior to an
opportunistic screening either in effectiveness (see the trend of CRC incidence)   or in efficiency
(see the Positive Predictive Value (PPV). This result should be discussed more in depth.
2) It would be useful to compare the B-PREDICT program and the OPP-COL in the  same age
range i.e. over the age 50. Please add a table considering only the FITs performed in the age
range 50-80.
3) Row 209 “cumulative participation rate” : what does it mean?  The proportion of invited
subject s who participated at least once ? . Generally speaking (for example in Northern Italy
see row 307) participation is calculated  and reported for each screening round. Please define the
term cumulative participation and report the participation at first round and subsequent round
4) Please report in table 2 the  Positive Predictive Value (PPV) for CRC and HRA. Such
parameter provides an estimate of the efficiency of the use of colonoscopy
Minor Points:
Row 6:  Title not Titel
Row 74: European Guidelines for CRC screening “ please reports it among references
Row  38 and row109: almost all screening programs are based on a screening test and on
subsequent examination for positive subject. In other words all screening programs are two stage
screening. I would suggest not to use such a term.
Fig 1 and Fig 2:   in the text is written that Opportunistic screening colonoscopy (OPP-COL)
is offered to inhabitants above 50 years whereas in the figures results  are reported also in the
age class 40-49 . Please explain the discrepancy
.
.
Title: Evaluation of the “Burgenland PREvention trial of colorectal cancer Disease with
ImmunologiCal Testing” (B-PREDICT) - a population-based colorectal cancer screening
program
Version: 2 Date: 22 Feb 2024
Reviewer's report:
The paper  Evaluation of the Burgenland PREvention trial of colorectal cancer Disease
with ImmunologiCal Testing” (B-PREDICT) - a population-based colorectal cancer screening
program by Bresina et al, compares the results (in terms of effectiveness  and efficiency) of
an organized Programme based on annual FIT testing from 40 to 80 as compared  with the
opportunistic screening colonoscopy (OPP-COL).
The issue is crucial  in order to choice the best colorectal screening policy and the results are
worth of interest although based on an observational study.
The way of reporting the results is different from how it is commonly done and sometimes
incomplete.
To my opinion , some clarification and some new analyses (if possible) would improve the
quality of the paper.
Mayor points:
1) The paper shows as an organized screening program (B-PREDICT9) is superior to an
opportunistic screening either in effectiveness (see the trend of CRC incidence)   or in efficiency
(see the Positive Predictive Value (PPV). This result should be discussed more in depth.
2) It would be useful to compare the B-PREDICT program and the OPP-COL in the  same age
range i.e. over the age 50. Please add a table considering only the FITs performed in the age
range 50-80.
3) Row 209 “cumulative participation rate” : what does it mean?  The proportion of invited
subject s who participated at least once ? . Generally speaking (for example in Northern Italy
see row 307) participation is calculated  and reported for each screening round. Please define the
term cumulative participation and report the participation at first round and subsequent round
4) Please report in table 2 the  Positive Predictive Value (PPV) for CRC and HRA. Such
parameter provides an estimate of the efficiency of the use of colonoscopy
Minor Points:
Row 6:  Title not Titel
Row 74: European Guidelines for CRC screening “ please reports it among references
Row  38 and row109: almost all screening programs are based on a screening test and on
subsequent examination for positive subject. In other words all screening programs are two stage
screening. I would suggest not to use such a term.
Fig 1 and Fig 2:   in the text is written that Opportunistic screening colonoscopy (OPP-COL)
is offered to inhabitants above 50 years whereas in the figures results  are reported also in the
age class 40-49 . Please explain the discrepancy
.
.
Please review this paper.
user
Title: Evaluation of the “Burgenland PREvention trial of colorectal cancer Disease with
ImmunologiCal Testing” (B-PREDICT) - a population-based colorectal cancer screening
program
Version: 2 Date: 22 Feb 2024
Reviewer's report:
The paper  Evaluation of the Burgenland PREvention trial of colorectal cancer Disease
with ImmunologiCal Testing” (B-PREDICT) - a population-based colorectal cancer screening
program by Bresina et al, compares the results (in terms of effectiveness  and efficiency) of
an organized Programme based on annual FIT testing from 40 to 80 as compared  with the
opportunistic screening colonoscopy (OPP-COL).
The issue is crucial  in order to choice the best colorectal screening policy and the results are
worth of interest although based on an observational study.
The way of reporting the results is different from how it is commonly done and sometimes
incomplete.
To my opinion , some clarification and some new analyses (if possible) would improve the
quality of the paper.
Mayor points:
1) The paper shows as an organized screening program (B-PREDICT9) is superior to an
opportunistic screening either in effectiveness (see the trend of CRC incidence)   or in efficiency
(see the Positive Predictive Value (PPV). This result should be discussed more in depth.
2) It would be useful to compare the B-PREDICT program and the OPP-COL in the  same age
range i.e. over the age 50. Please add a table considering only the FITs performed in the age
range 50-80.
3) Row 209 “cumulative participation rate” : what does it mean?  The proportion of invited
subject s who participated at least once ? . Generally speaking (for example in Northern Italy
see row 307) participation is calculated  and reported for each screening round. Please define the
term cumulative participation and report the participation at first round and subsequent round
4) Please report in table 2 the  Positive Predictive Value (PPV) for CRC and HRA. Such
parameter provides an estimate of the efficiency of the use of colonoscopy
Minor Points:
Row 6:  Title not Titel
Row 74: European Guidelines for CRC screening “ please reports it among references
Row  38 and row109: almost all screening programs are based on a screening test and on
subsequent examination for positive subject. In other words all screening programs are two stage
screening. I would suggest not to use such a term.
Fig 1 and Fig 2:   in the text is written that Opportunistic screening colonoscopy (OPP-COL)
is offered to inhabitants above 50 years whereas in the figures results  are reported also in the
age class 40-49 . Please explain the discrepancy
.
.
assistant