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We compared the diagnostic efficacies of miR-92a, immunochemical fecal occult blood testing (FIT), and their combination (FIT\u2009+\u2009miR-92a) in a prospective multicenter screening trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Overall, 16,240 participants aged 30\u201375\u00a0years were enrolled between April 1, 2021, and December 31, 2023. A total of 15,586 participants returned samples available for both FIT and miR-92a tests. All those with positive, and a random selection of those with negative screening tests were recommended to undergo colonoscopy. Follow-ups were performed until participants completed the colonoscopic examination. A total of 1401 screen-positive and 2079 randomly selected screen-negative individuals completed colonoscopies. Primary outcomes included sensitivity, number needed to screen (NNS), Youden index and receiver operating characteristic area under the curve (AUC) for advanced adenomas and colorectal cancer [advanced neoplasia (AN)] for each screening modality in the diagnostic performance analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Colonoscopy was performed in 3480 individuals. The colonoscopy compliance rate was 47.8% for screen-positive individuals. The sensitivity of miR-92a versus FIT for AN was 70.9% versus 54.3% (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), NNS was 24.7 versus 32.2 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), Youden index was 47.9% versus 35.0% (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), AUC was 0.74 versus 0.67 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.010). FIT\u2009+\u2009miR-92a had a sensitivity of 85.4%, an NNS of 20.5, a Youden index of 47.9% and an AUC of 0.74 for AN.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For AN screening, miR-92a demonstrated better sensitivity, NNS, Youden index and AUC as compared with FIT. Compared with FIT, using miR-92a appears to be more efficient for population-based screening programs. Screening sensitivity for AN can be further enhanced if conditionally used in combination with FIT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic>Trial registration<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Chinese Clinical Trial Registration Number: ChiCTR2200065415.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40779-025-00613-3","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T22:19:29Z","timestamp":1749766769000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic efficacy of fecal-based miR-92a for advanced colorectal neoplasia: a prospective multicenter screening 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Accessed 29 May 2020."}],"container-title":["Military Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40779-025-00613-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40779-025-00613-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40779-025-00613-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:53:06Z","timestamp":1772830386000},"score":1,"resource":{"primary":{"URL":"https:\/\/mmrjournal.biomedcentral.com\/articles\/10.1186\/s40779-025-00613-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,13]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["613"],"URL":"https:\/\/doi.org\/10.1186\/s40779-025-00613-3","relation":{},"ISSN":["2054-9369"],"issn-type":[{"value":"2054-9369","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,13]]},"assertion":[{"value":"2 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical reviews were conducted separately by the ethics committees of each clinical center [Ethics review committee of Shenzhen People\u2019s Hospital (SYL-202123-03); Ethics review committee of Shenzhen Bao\u2019an District Hospital of Traditional Chinese Medicine (SJ-2021-001-04); Ethics review committee of Tianjin Nankai Hospital (NKYY_YX_IRB_2021_002)], with final approval from the group leader at Shenzhen People\u2019s Hospital. 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