Strengthening colonoscopy screening in primary care: A preventive imperative before the coming surge

India stands at a critical juncture in its cancer control efforts. While cervical, breast, and oral cancers receive substantial screening attention, colorectal cancer (CRC), a largely preventable disease, remains conspicuously absent from the national preventive health agenda. With approximately 70,000 new cases and 41,000 deaths annually, and projections indicating a doubling of this burden by 2050, the time for complacency has passed. Colonoscopy screening, proven globally to reduce mortality by over 30%, represents an underutilized intervention that could spare hundreds of thousands of lives in India. This editorial argues for the urgent integration of systematic CRC screening into India's primary healthcare framework before demographic and lifestyle shifts render the problem unmanageable.