Bridging the equity gap in colorectal cancer screening: A comparative analysis across high-income countries

Despite the availability of colorectal cancer (CRC) screening programs in high-income countries (HICs), disparities in access and outcomes persist. Equity-focused policies are essential to ensure that CRC prevention reaches all population groups, particularly those underserved or marginalized.

We conducted a comparative policy analysis of CRC screening systems across ten HICs using peer-reviewed literature, national cancer agency reports, and updated screening data. Two summary tables were developed: one detailing screening modalities, coverage rates, and intervals; the other outlining equity-focused policies, gaps, and country-specific recommendations.

The analysis revealed substantial variation in screening modalities and coverage rates, with organized, population-based programs generally achieving higher uptake. Equity-focused policies varied widely, with common gaps including limited outreach in rural areas, under-screening among minority populations, and insufficient equity data collection. Recommendations included expanding culturally tailored education, improving data systems, and embedding equity metrics into national strategies.

This study contributes to the growing evidence base on health equity in cancer prevention by offering a replicable framework for cross-country policy benchmarking. The findings underscore the importance of integrating equity into CRC screening programs to reduce disparities and improve outcomes across diverse health systems.