Colorectal cancer population screening programs worldwide in 2016: An update

Area of Science:

• Oncology
• Public Health
• Gastroenterology

Background:

• Colorectal cancer (CRC) is a leading global cancer diagnosis with significant geographical variations in incidence and mortality.
• Screening is crucial for reducing CRC incidence and mortality, yet implementation strategies and detection methods differ widely.
• Existing literature presents a complex landscape of CRC screening program effectiveness and reach.

Purpose of the Study:

• To review and present the results and strategies of various colorectal cancer screening programs implemented globally.
• To analyze the effectiveness and reach of different screening modalities and participation rates across diverse geographical regions.
• To synthesize findings from literature, web pages, and clinical guidelines on international CRC screening efforts.

Main Methods:

• Comprehensive literature review of national and international colorectal cancer screening programs.
• Inclusion of studies published in PubMed, relevant web pages, and established clinical guidelines.
• Analysis of screening strategies, participation rates, and detection outcomes across different programs.

Main Results:

• CRC screening programs are active across Europe, North America, South America, Asia, and Oceania.
• Fecal occult blood testing (FOBT) and fecal immunochemical test (FIT) are the predominant screening strategies, with FIT being the most widely adopted.
• Participation rates varied significantly (16% in Canada to 68.2% in the Netherlands), with higher engagement observed among women and in FIT-based programs. Men showed higher positive results.

Conclusions:

• The fecal immunochemical test (FIT) has become the most prevalent colorectal cancer screening method globally.
• FIT implementation has demonstrably increased screening participation rates and the detection of positive results.
• Continued global implementation and optimization of screening programs, particularly those utilizing FIT, are essential for CRC control.