Wang YX, Wang KJ. Who should be screened for colorectal cancer and how can it be prevented more effectively? World J Gastrointest Oncol 2024; 16(9): 3741-3746 [DOI: 10.4251/wjgo.v16.i9.3741]
Corresponding Author of This Article
Kai-Juan Wang, MD, PhD, Professor, College of Public Health, Key Laboratory of Tumor Epidemiology of Henan Province, State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou 450001, Henan Province, China. kjwang@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Sep 15, 2024; 16(9): 3741-3746 Published online Sep 15, 2024. doi: 10.4251/wjgo.v16.i9.3741
Who should be screened for colorectal cancer and how can it be prevented more effectively?
You-Xiang Wang, Kai-Juan Wang
You-Xiang Wang, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
Kai-Juan Wang, College of Public Health, Key Laboratory of Tumor Epidemiology of Henan Province, State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou 450001, Henan Province, China
Author contributions: Wang YX designed the overall concept and outline of the manuscript; Wang KJ contributed to the discussion and design of the manuscript; Wang YX and Wang KJ contributed to the writing and editing the manuscript, illustrations, and review of the literature.
Conflict-of-interest statement: The authors declare that they have nothing to disclose 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: Kai-Juan Wang, MD, PhD, Professor, College of Public Health, Key Laboratory of Tumor Epidemiology of Henan Province, State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou 450001, Henan Province, China. kjwang@163.com
Received: March 9, 2024 Revised: May 7, 2024 Accepted: May 28, 2024 Published online: September 15, 2024 Processing time: 184 Days and 0.6 Hours
Abstract
In this editorial, we comment on the article published by Agatsuma et al in a recent issue of the World J Gastroenterol (2024; 30: 1368-1376). We firmly concur with Agatsuma et al regarding the vital significance of colorectal cancer (CRC) screening as a public health strategy to diminish disease burden. Individuals exposed to risk factors for CRC, those with comorbid conditions, and those with limited health literacy should undergo screening. However, we believe that more regular screenings should be accompanied by a greater focus on primary prevention (PP) of CRC. CRC remains a significant global health challenge, and its incidence is strongly linked to age, lifestyle, and socioeconomic factors. It is particularly noteworthy that the majority of CRC patients are diagnosed outside of established screening pathways and frequently at an advanced stage of the disease, and the majority of patients possess inadequate or even nonexistent knowledge regarding CRC, which significantly impacts the prognosis and imposes a substantial economic burden. This study revealed that CRC identified during hospital visits for comorbid conditions was typically diagnosed at an earlier stage than detected via symptomatic pathways. Remarkably, early incidental detection of CRC aligns closely with the timing of discovery through routine cancer screenings. This suggests that by adopting more inclusive screening protocols that combine opportunistic testing with traditional screening methods, health care systems can create a more comprehensive safety net for individuals at risk of CRC. However, before maximizing the health benefits of screening programs, it is essential to make additional efforts prior to screening, such as raising awareness via public education, risk assessment, and personalized recommendations, enhancing the knowledge and skills of health care professionals, optimizing the accessibility and convenience of screening processes, ensuring the quality and safety of screening services, strengthening follow-up and support systems, and providing policy support and financial investment. The establishment of a comprehensive screening system often requires substantial investment in human, material, and financial resources, which can be challenging to achieve in regions with limited health care resources. Strengthening PP strategies can reduce the disease burden by targeting the cause, representing a more cost-effective and impactful approach. Establishing a comprehensive cancer PP service platform that integrates authoritative public education on malignant tumor PP, individualized malignant tumor risk assessment, and self-health management assistance accessible to the entire population will significantly enhance the overall effectiveness of CRC PP strategies.
Core Tip: Most colorectal cancer (CRC) patients are identified outside standard screening protocols, and CRC is frequently diagnosed at an advanced stage through clinical methods. The effectiveness of screening initiatives is limited by factors such as recognizing the importance of screening, screening methodologies and their frequency, economic development, and the scope of coverage. Thus, the implementation of primary prevention strategies, which include enhancing awareness of CRC and controlling exposure to its risk factors, is the most effective approach for the prevention of CRC.