[Colorectal cancer screening: situation and prospect]

Area of Science:

• Oncology
• Public Health
• Gastroenterology

Background:

• Colorectal cancer (CRC) is a leading cause of cancer mortality in China, with increasing incidence.
• Adenoma-to-carcinoma progression, the primary pathway for CRC, occurs over decades, highlighting the importance of early detection.
• Effective CRC screening strategies are crucial for improving patient survival rates.

Discussion:

• Fecal occult blood testing and flexible sigmoidoscopy are established CRC screening methods proven to reduce mortality.
• The role of colonoscopy in CRC screening requires further confirmation through randomized clinical trials.
• Historical CRC screening efforts in China, particularly in Zhejiang province since the 1970s, have informed current guidelines.

Key Insights:

• CRC screening targets average-risk populations to identify pre-cancerous lesions and early-stage cancers.
• Early detection via screening is the key strategy for enhancing CRC survival.
• Established screening methods like fecal occult blood tests and flexible sigmoidoscopy demonstrate efficacy in reducing CRC mortality.

Outlook:

• Further research is needed to validate the effectiveness of colonoscopy in CRC screening programs.
• Continued development and implementation of standardized CRC screening guidelines are essential for public health.
• Leveraging past screening experiences can inform future strategies for CRC prevention and control in China.