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Organizing Screening in the Asian-Pacific Region: Challenges, Experience, Outlook

Organizing Screening in the Asian-Pacific Region: Challenges, Experience, Outlook

19 Aug 2021 12:30 12:55
(25 mins)
Yeoh Khay-Guan Speaker
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Colorectal Cancer (CRC) is the second leading cause of cancer-related deaths worldwide in 2020 (Sung et al., 2021). Screening and early detection is critical for reducing CRC mortality. In areas with high CRC incidence, population screening for CRC has been recommended, particularly so in the Asia Pacific (APAC) region (Sung et al., 2015), which accounts for over half the global incidence in 2020. APAC countries/ territories that have launched nationwide population-based screening programmes using fecal immunochemistry test (FIT) include Japan, South Korea, Singapore and Taiwan, and reduction of CRC mortality has also been reported (Schreuders et al., 2015; Rabeneck et al., 2020). However, challenges remain for these countries/territories with existing screening programmes. Generally, the uptake rate of screening in these countries/territories remains low, and there is also poor compliance with colonoscopy as compared to Western programmes (Chiu et al., 2017). These could be a result of low awareness and perceived need for CRC screening, as well as potential barriers such as financial and access barriers, as revealed by the previous surveys (Koo et al., 2012). To improve effectiveness of screening programmes and outcomes, best practices would have to be diligently implemented, such as engaging primary care physician for screening recommendation, improving public’s awareness of CRC screening and risk factors, lowering barriers and increasing compliance with colonoscopy through close monitoring and follow-ups. Furthermore, the Asia Pacific Consensus (Sung et al., 2015) had recommended use of risk stratification in screening, such as that of the modified Asia-Pacific Colorectal Screening (APCS) score (Yeoh et al., 2011; Sung et al., 2018). The high risk subjects could be prioritised for screening or for higher-intensity surveillance. Success with these approaches will improve survival outcomes for CRC.

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