A large-scale randomized controlled trial was conducted to compare different colorectal neoplasms screening strategies.

Inclusion Criteria:

• 50-74 years old
• Informed consent is available

Exclusion Criteria:

• Previous colorectal cancer
• Previous colorectal resection
• Previous received cancer-related treatment (except non-melanoma skin cancer)
• Colonoscopy, sigmoidoscopy, CT colonoscopy, and barium enema were performed within 5 years
• Fecal occult blood or fecal DNA was performed within one year
• Symptoms of lower digestive tract diseases requiring colonoscopy include: (1) rectal bleeding occurred more than once in the past 6 months, (2) recorded iron deficiency anemia, and (3) recorded significant weight loss within 6 months (> 10% of baseline weight)
• Suffering from other diseases that affect the benefit of screening or intolerance to colonoscopy (for example, severe pulmonary disease, end-stage renal disease, end-stage liver disease, severe heart failure or recently diagnosed cancer, except non-melanoma skin cancer)