Effectiveness of the Korean National Cancer Screening Program in Reducing Colorectal Cancer Mortality

Area of Science:

• Oncology
• Public Health
• Preventive Medicine

Background:

• Colorectal cancer (CRC) screening effectiveness, particularly with fecal immunochemical tests (FIT), requires further clarification.
• South Korea's National Cancer Screening Program (KNCSP) has offered CRC screening via FIT to individuals aged 50 and older since 2004.

Purpose of the Study:

• To evaluate the impact of the KNCSP on reducing CRC-specific mortality.
• To assess the effectiveness of FIT screening in a large-scale national program.

Main Methods:

• A nested case-control study utilized KNCSP database data from 5,944,540 cancer-free individuals aged ≥50 years.
• Matched analysis compared cases (n=29,992 deaths post-CRC diagnosis) with controls.
• Conditional logistic regression analyzed screening effects on CRC-specific mortality by age group.

Main Results:

• Ever screened individuals had a 26% lower odds of CRC-specific mortality (OR 0.74; 95% CI, 0.71-0.76) compared to never screened.
• Increased screening frequency correlated with decreased CRC-specific mortality.
• Screening benefits were significant for ages 50-74, with non-significant results for 75-79 and opposite trends in those ≥80.

Conclusions:

• National CRC mass screening using FIT is effective for individuals aged 50-74 years.
• The findings support the implementation of FIT screening for individuals aged 50-74 in national programs.
• Age-specific considerations are crucial for optimizing CRC screening strategies.