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There is no doubt that colorectal cancer is a relevant concern for public health. Effective screening protocols have proven to reduce its incidence and mortality. Evidence provided by randomized control trials (RCTs) is ideal to set a new intervention as the gold standard for prevention.
This is because RCTs makes groups comparable without confusions, sets a clear baseline and when it's well designed its results can be translated into the clinical practice right away. In the other hand they can be expensive and long time demanding among other things.
The colonoscopy is an useful tool for diagnosis, treatment and prevention of CRC. It is an issue that seems to be clear in the clinical practice, however there are none RCTs about this. Xabier García Albéniz was at the Hospital Clínic of Barcelona and performed an emulation of the design and necessary data to achieve this high quality of evidence and also proposed several alternatives to obtain valuable data.