BMC Cancer (Apr 2025)

A study protocol for the CHinA National CancEr screening (CHANCES) trial: a randomized controlled study to compare the screening strategies for lung cancer and colorectal cancer

  • Yibo Gao,
  • Ping Hu,
  • Ning Wu,
  • Fengwei Tan,
  • Wei Cao,
  • Wei Tang,
  • Fei Wang,
  • Jiang Li,
  • Xin Li,
  • Yan Wen,
  • Yongjie Xu,
  • Yiwen Yu,
  • Chao Qin,
  • Xuesi Dong,
  • Jiansong Ren,
  • Zhuoyu Yang,
  • Yadi Zheng,
  • Zheng Wu,
  • Paul Pinsky,
  • Philip Prorok,
  • Martina Taylor,
  • Ni Li,
  • Barnett Kramer,
  • Jie He

DOI
https://doi.org/10.1186/s12885-025-14152-6
Journal volume & issue
Vol. 25, no. 1
pp. 1 – 8

Abstract

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Abstract Background Well-implemented cancer screening strategies can significantly enhance early detection rates, leading to improved treatment outcomes and reduced mortality. However, there remains a paucity of high-quality evidence from developing regions. The CHinA National CancEr Screening (CHANCES) Trial aims to comprehensively evaluate and compare different screening strategies for lung cancer and colorectal cancer (CRC) in the Chinese population. Methods The CHANCES trial is a randomized controlled trial aimed at assessing the effectiveness of screening using low-dose computed tomography (LDCT) either annually or biennially for reducing lung cancer-specific mortality. Additionally, our trial seeks to evaluate the efficacy of various screening strategies for CRC. In this 5-year project, a total of 105,600 participants aged 50–74 from 25 provinces will be enrolled and randomized into one of three arms: (i) receiving five annual LDCT scans along with a single colonoscopy (n = 26,400); (ii) undergoing three biennial LDCT scans and five annual fecal blood tests using fecal immunochemical testing (FIT) (n = 39,600); (iii) opting for either a single colonoscopy or five annual FIT tests (n = 39,600). Participants with positive FIT findings will be recommended to undergo a diagnostic colonoscopy. The primary endpoint of this study is lung cancer-specific mortality, and cost-effectiveness analyses of the various screening strategies in the Chinese population are also planned. Discussion To our knowledge, this trial represents the first endeavor statistically powered to assess the potential reduction in lung-cancer-specific mortality through screening with LDCT annually or biennially compared to a no screening arm. Additionally, it seeks to explore the feasibility of integrating lung cancer and CRC screening in a developing nation setting. The anticipated findings from this study hold the potential to provide evidence-based recommendations for cancer screening programs, thereby advancing cancer prevention and control efforts not only in China but also globally. Trial registration ChiCTRN(Chinese Clinical Trial Registry Number), ChiCTR1900025257. Registered on 2019-08-18.

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