{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:03:59Z","timestamp":1784199839160,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Colorectal cancer (CRC) is the second leading cause of tumour\u2010related mortality worldwide, accounting for approximately 903,000 deaths annually. Despite the proven effectiveness of population\u2010based screening in reducing mortality, participation rates remain suboptimal, hindered by cognitive, psychological, and socioeconomic barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study assessed the effectiveness of the PREVenGO smartphone application, a digital decision aid (DA) incorporating personalisation and gamification elements, in supporting informed decision\u2010making and adherence to CRC screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>DA\u2010CRC is a two\u2010arm randomised controlled pilot trial. Individuals born in 1973\u20131974 and invited for the first time to the CRC screening programme by the Local Health Authority of Brescia (Northern Italy) were eligible. Invitation letters included instructions to download the PREVenGO app, which randomised participants into intervention or control arms. The intervention app integrated questionnaires on family history, prevention knowledge, and locus of control (LoC), together with gamified features and rewards, while the control version provided static educational material. Both groups received follow\u2010up notifications at 3 (T1) and 6\u2009months (T2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among those invited, 1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009248) downloaded the app and completed onboarding. Follow\u2010up retention was limited: only 18 participants (7.3%) completed the 3\u2010month questionnaire (T1) and 1 (0.4%) the 6\u2010month assessment (T2). The overall faecal occult blood test (FOBT) screening uptake was 86.7% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009215), with comparable rates in both arms (control: 84.3%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009102; intervention: 89.0%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009113;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.278). Only 17% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200943) of participants met all Marteau framework criteria for informed choice, with critical knowledge gaps, particularly regarding overdiagnosis, false positives, and absolute screening benefit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preliminary findings suggest that a digital DA with personalised and gamified content may enhance CRC screening uptake and partially support informed choice. Larger, multisite studies are warranted to evaluate scalability, inclusivity, and long\u2010term effectiveness in population\u2010based cancer prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      RCT n. NCT07269028. (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT07269028?term=NCT07269028&amp;rank=1\">https:\/\/clinicaltrials.gov\/study\/NCT07269028?term=NCT07269028&amp;rank=1<\/jats:ext-link>\n                      )\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71991","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T05:16:49Z","timestamp":1780118209000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Personalised and Gamified Digital Decision Aid for Colorectal Cancer Screening: A Randomised Controlled Pilot Study"],"prefix":"10.1002","volume":"15","author":[{"given":"Mattia","family":"Celebrin","sequence":"first","affiliation":[{"name":"Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7381-0869","authenticated-orcid":false,"given":"Asia","family":"Filosa","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Anelli","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Brucchi","sequence":"additional","affiliation":[{"name":"University of Milan  Milan Italy"},{"name":"Division of General and Endocrine Surgery IRCCS Istituto Auxologico Italiano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"La Torraca Vittori","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioural Sciences University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Incremona","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Physics \u201cNiccol\u00f3 Tartaglia\u201d; Faculty of Mathematical, Physical and Natural Sciences Universit\u00e0 Cattolica del Sacro Cuore  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Rogledi","sequence":"additional","affiliation":[{"name":"Department of Industrial and Information Engineering University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Summer","sequence":"additional","affiliation":[{"name":"School of Physics Trinity College  Dublin Ireland"},{"name":"Trinity Quantum Alliance  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Vizzardi","sequence":"additional","affiliation":[{"name":"Department of Public Health and Preventive Medicine ATS Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Ghidini","sequence":"additional","affiliation":[{"name":"Department of Public Health and Preventive Medicine ATS Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Bregoli","sequence":"additional","affiliation":[{"name":"Department of Public Health and Preventive Medicine ATS Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enri","family":"Hoxha","sequence":"additional","affiliation":[{"name":"Department of Public Health and Preventive Medicine ATS Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Marazza","sequence":"additional","affiliation":[{"name":"Department of Public Health and Preventive Medicine ATS Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Gorini","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health (Department of Excellence 2023\u20102027) University of Milan  Milan Italy"},{"name":"Istituti Clinici Scientifici Maugeri IRCCS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Montomoli","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21457"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100032\u20101325997"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20104\u201075"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7417.736"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001431.pub5"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241703"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416\u2010020\u20100935\u20102"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1037\/10788-000"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1108\/JOSM\u201004\u20102016\u20100116"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.2196\/12103"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.2196\/17790"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.2196\/23786"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.2196\/17039"},{"key":"e_1_2_13_16_1","unstructured":"L.PietroandP. M.Emanuela \u201cGulpease: Una Formula Per La Predizione Della Leggibilita Di Testi in Lingua Italiana \u201d(1988)."},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0738\u20103991(02)00089\u20107"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1369\u20106513.2001.00140.x"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/109019817800600107"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)60123\u20104"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.6016"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq099"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605388"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102014\u2010308081"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.1756"}],"updated-by":[{"DOI":"10.1002\/cam4.72069","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T00:00:00Z","timestamp":1782000000000}}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71991","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.71991","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71991","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T10:04:17Z","timestamp":1784196257000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.71991"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/cam4.71991"],"URL":"https:\/\/doi.org\/10.1002\/cam4.71991","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]},"assertion":[{"value":"2025-11-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71991"}}