Colorectal Cancer Screening Interventions and Disparities
Summary
Colorectal cancer remains a leading cause of cancer mortality worldwide, yet early detection through screening substantially reduces both incidence and death rates. Screening methods include stool-based tests and endoscopic examinations, each offering distinct benefits and limitations. Despite demonstrated effectiveness, considerable disparities persist in screening uptake, influenced by factors such as age, socioeconomic status, geographic location and ethnicity. Rural communities and marginalised populations often face barriers including limited access to specialist services, out-of-pocket costs, lack of clear provider recommendation and low awareness. Recent shifts in incidence towards younger age groups have prompted guideline reviews and modelling studies to assess the impact of lowering the screening threshold. Efforts to enhance participation have concentrated on organised population-based programmes, multicomponent interventions in primary care and tailored outreach in underserved settings. Implementation science frameworks have been employed to adapt interventions to local contexts, with ongoing evaluation of fidelity, cost-effectiveness and equity outcomes. Understanding and addressing the root causes of screening disparities is central to achieving global targets for colorectal cancer control.
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Colorectal Cancer Screening Interventions and Disparities publication trend
The graph below shows the total number of articles in colorectal cancer screening interventions and disparities across all publications each year (not limited to Nature Index journals).
Technical terms
Colorectal cancer (CRC): Malignant tumour arising in the colon or rectum, often developing from precancerous polyps.
Faecal immunochemical test (FIT): Non-invasive assay detecting human haemoglobin in stool, used for population screening.
Quality-adjusted life-year (QALY): Composite measure of health benefit that accounts for both quantity and quality of life gained.
Microsimulation modelling: Computational approach simulating individual life histories to project intervention outcomes in a population.
References
- Association of Reducing the Recommended Colorectal Cancer Screening Age With Cancer Incidence, Mortality, and Costs in Canada Using OncoSim. JAMA Oncology (2023).
- Vital Signs: Colorectal Cancer Screening Test Use — United States, 2018. MMWR Morbidity and Mortality Weekly Report (2020).
- A systematic review of clinic and community intervention to increase fecal testing for colorectal cancer in rural and low-income populations in the United States – How, what and when?. BMC Cancer (2018).
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