Future of Colorectal Cancer Screening: From One-Size-FITs-All to Tailor-Made

Area of Science:

• Oncology
• Preventive Medicine
• Biomarker Research

Background:

• Colorectal cancer (CRC) screening reduces mortality, but current methods like colonoscopy are costly and have low participation.
• Fecal immunochemical tests (FIT) are non-invasive and inexpensive but suffer from low sensitivity for advanced neoplasia and high false positivity rates, leading to unnecessary procedures.

Purpose of the Study:

• To review the development of risk-based screening models for colorectal cancer (CRC).
• To discuss challenges in implementing these novel risk models into existing CRC screening programs.

Main Methods:

• Literature review of risk models for CRC screening.
• Analysis of cross-sectional and longitudinal risk models incorporating multiple risk factors and biomarkers.

Main Results:

• Risk models offer a potential improvement over current CRC screening methods.
• Existing risk models face obstacles for widespread implementation in public health programs.

Conclusions:

• Novel risk-based strategies are needed to enhance the effectiveness and efficiency of colorectal cancer (CRC) screening.
• Overcoming implementation barriers is crucial for the successful integration of advanced risk models into population-based CRC screening programs.