Korean Colorectal Cancer Screening Guidelines for Asymptomatic, average-Risk Adults: The 2025 Revision.

Area of Science:

• Oncology
• Public Health
• Evidence-Based Medicine

Background:

• Colorectal cancer (CRC) remains a significant public health concern globally.
• Regular screening is crucial for early detection and improved patient outcomes.
• Previous guidelines require updates based on emerging scientific evidence and domestic data.

Purpose of the Study:

• To update the 2025 Korean CRC screening guidelines.
• To systematically review recent evidence and integrate domestic data.
• To provide evidence-based standards for clinicians and policymakers.

Main Methods:

• A multidisciplinary committee utilized the GRADE methodology.
• Systematic review of international guidelines and 327 primary studies.
• Markov model-based cost-utility analysis for optimal screening parameters.

Main Results:

• High-certainty evidence supports Fecal Immunochemical Test (FIT) for reducing CRC mortality.
• Moderate-certainty evidence supports colonoscopy.
• Conditional recommendations for screening adults aged 45-74 with colonoscopy (10 years) or FIT (1-2 years).
• CT colonography and stool DNA testing not recommended due to low certainty evidence.

Conclusions:

• The 2025 guidelines offer updated, evidence-based CRC screening recommendations for South Korea.
• Conditional adoption of colonoscopy and FIT for average-risk adults aged 45-74.
• Aims to optimize public health and decrease the CRC burden domestically.