Uptake of Colorectal Cancer Screening in Low- and Middle-Income Countries: a Systematic Review and Meta-analysis

Area of Science:

• Public Health
• Oncology
• Epidemiology

Background:

• Colorectal cancer (CRC) poses a significant global health challenge, particularly in low- and middle-income countries (LMICs).
• CRC screening is proven to reduce cancer incidence and mortality.
• Uptake data for CRC screening in LMICs is limited, necessitating further investigation.

Purpose of the Study:

• To quantify the uptake of colorectal cancer screening modalities in LMICs.
• To provide a comprehensive overview of current screening practices in resource-limited settings.

Main Methods:

• Systematic review and meta-analysis of observational studies.
• Searched multiple databases (Scopus, Embase, PubMed, Web of Knowledge) for literature up to August 2024.
• Pooled prevalence of CRC screening uptake using a random-effects model and conducted subgroup analyses.

Main Results:

• Included 69 studies from 19 LMICs.
• Pooled prevalence of self-reported screening colonoscopy uptake was 5.2%.
• Pooled prevalence of self-reported fecal occult blood test (gFOBT) uptake was 11.5%.
• Overall pooled prevalence for any CRC screening modality was 9.1%.

Conclusions:

• Colorectal cancer screening rates are alarmingly low in LMICs.
• Low uptake impedes early detection and increases mortality.
• Context-specific strategies are essential to enhance CRC screening uptake in LMICs.