Global colorectal cancer screening programs and coverage rate estimation: an evidence synthesis

Area of Science:

• Public Health
• Oncology
• Epidemiology

Background:

• Colorectal cancer (CRC) screening is crucial for reducing disease burden.
• Screening effectiveness hinges on participation and coverage rates.
• Global CRC screening program characteristics and coverage require comprehensive assessment.

Purpose of the Study:

• To systematically review global colorectal cancer screening program characteristics.
• To assess current global screening coverage rates.
• To analyze temporal trends and subgroup variations in CRC screening coverage.

Main Methods:

• Systematic literature search of PubMed and Embase databases.
• Inclusion of grey literature from screening program websites and reports.
• Analysis of nationwide CRC screening coverage data from 45 countries.

Main Results:

• Thirty-three countries provided coverage rates, showing significant variation (1.0% in China to 79.4% in Finland).
• Fecal occult blood testing is the most common modality; European countries dominate population-based programs.
• Coverage generally increased with age and showed slight differences between sexes; most countries demonstrated stable or increasing trends over time.

Conclusions:

• Significant global disparities exist in colorectal cancer screening implementation.
• Targeted strategies are essential to enhance participation and expand screening coverage, especially in high-burden regions.
• Improving screening access is vital for reducing the overall impact of colorectal cancer.