Colorectal cancer screening of the general population in East Asia

Abstract

In recent years, the incidence of colorectal cancer (CRC) has been increasing, and CRC has been becoming the major cause of cancer deaths in Asian countries. Therefore, an organized screening program to reduce CRC incidence and mortality is currently implemented in each country. In the present review, we summarize the current status and future perspectives of CRC screening of the general population in East Asian and South-East Asian countries. The fecal occult blood test is widely used for CRC screening in these countries, and its effectiveness in reducing CRC incidence and mortality has been demonstrated; however, the low participation rate in CRC screening programs is a problem to be solved in every country. Improvement in the public awareness of CRC and promotion of CRC screening by physicians will help to raise the participation rate and reduce the number of deaths caused by CRC. Regarding screening colonoscopy, several studies have recently demonstrated its effectiveness in reducing CRC incidence and mortality. However, at present, CRC screening colonoscopy is not adopted as a primary population-based screening tool because of staffing constraints in relation to large population sizes, increased medical costs, and potential adverse events (e.g. perforation and drug-induced anaphylaxis). Further study is required to consider colonoscopy as CRC screening that is established in Western countries.

Community‐based survey of knowledge of, attitudes to and practice of colorectal cancer screening in Hong Kong

“…Our data may also be useful to policy makers in countries that are planning and implementing population‐based CRC screening, like China. The low rate of participation in screening is considered the biggest obstacle to achieving a reduction of CRC mortality . Population‐based CRC screening programs will achieve better results when the potential motivations and barriers to screening are properly understood.…”

“…The low rate of participation in screening is considered the biggest obstacle to achieving a reduction of CRC mortality. 18 Population-based CRC screening programs will achieve better results when the potential motivations and barriers to screening are properly understood. This will result in a higher participation rate and better coverage of the at-risk population.…”

Colorectal cancer population screening programs worldwide in 2016: An update

“…These barriers included poor understanding of the characteristics of screening and testing, lack of financial support, and lack of health insurance[49]. Several countries in East Asia have ongoing organized screening programs, including Japan, Korea, China, Hong Kong, Taiwan, and Bangkok[50]. The results for several of these CRC Screening Programs are described below and in Table 4.…”

Multiplex methylated DNA testing in plasma with high sensitivity and specificity for colorectal cancer screening

“…Due to its invasiveness, bothersome bowel preparation and difficult‐to‐avoid complications, colonoscopy had shown low acceptance rate despite being the gold standard for CRC screening . Moreover, it is hardly a primary CRC screening method in developing countries with limited resources including China, where FOBT is the most widely used CRC screening method albeit with low accuracy . Hence, a non‐invasive and more accurate screening method need to be developed to promote early CRC screening.…”