Review
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Apr 15, 2024; 16(4): 1119-1133
Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1119
Colorectal cancer screening: A review of current knowledge and progress in research
Sara Ramos Lopes, Claudio Martins, Inês Costa Santos, Madalena Teixeira, Élia Gamito, Ana Luisa Alves
Sara Ramos Lopes, Claudio Martins, Inês Costa Santos, Madalena Teixeira, Élia Gamito, Ana Luisa Alves, Department of Gastroenterology, Centro Hospitalar de Setúbal, Setúbal 2910-446, Portugal
Author contributions: Lopes SR and Martins C reviewed the literature and wrote the manuscript; Lopes SR, Martins C, Santos IC, Teixeira M, Gamito É, and Alves AL have read and approved the final version of the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Claudio Martins, MD, Doctor, Department of Gastroenterology, Centro Hospitalar de Setúbal, Rua Camilo Castelo Branco, Setúbal 2910-446, Portugal. cmartins1@campus.ul.pt
Received: December 28, 2023
Peer-review started: December 28, 2023
First decision: January 4, 2024
Revised: January 16, 2024
Accepted: February 18, 2024
Article in press: February 18, 2024
Published online: April 15, 2024
Processing time: 104 Days and 21.6 Hours
Abstract

Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide, being the third most commonly diagnosed malignancy and the second leading cause of cancer-related deaths globally. Despite the progress in screening, early diagnosis, and treatment, approximately 20%-25% of CRC patients still present with metastatic disease at the time of their initial diagnosis. Furthermore, the burden of disease is still expected to increase, especially in individuals younger than 50 years old, among whom early-onset CRC incidence has been increasing. Screening and early detection are pivotal to improve CRC-related outcomes. It is well established that CRC screening not only reduces incidence, but also decreases deaths from CRC. Diverse screening strategies have proven effective in decreasing both CRC incidence and mortality, though variations in efficacy have been reported across the literature. However, uncertainties persist regarding the optimal screening method, age intervals and periodicity. Moreover, adherence to CRC screening remains globally low. In recent years, emerging technologies, notably artificial intelligence, and non-invasive biomarkers, have been developed to overcome these barriers. However, controversy exists over the actual impact of some of the new discoveries on CRC-related outcomes and how to effectively integrate them into daily practice. In this review, we aim to cover the current evidence surrounding CRC screening. We will further critically assess novel approaches under investigation, in an effort to differentiate promising innovations from mere novelties.

Keywords: Colorectal cancer; Screening; Review; Oncology; Artificial intelligence

Core Tip: Despite progress in screening and early diagnosis, a significant proportion (approximately 20%-25%) of patients diagnosed with colorectal cancer still exhibit metastatic disease at the time of their initial diagnosis. Various screening tests are available, differing in invasiveness and preparation requirements. Nevertheless, adherence rates remain suboptimal. While new and promising methods are emerging to address these challenges, further research is needed before its integration in clinical practice.