Ola Idris, Cardoso Rafael, Hoffmeister Michael, Brenner Hermann
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.
Medical Faculty Heidelberg, University of Heidelberg, 69120, Heidelberg, Germany.
EClinicalMedicine. 2024 Aug 21;75:102783. doi: 10.1016/j.eclinm.2024.102783. eCollection 2024 Sep.
The substantial and increasing global burden of colorectal cancer (CRC) underscores the imperative to enhance implementation and utilization of effective CRC screening offers. Therefore, we examined the lifetime and up-to-date use of CRC screening tests across various countries, and described utilization trends over time.
We conducted a systematic review on the extent and recent trends of utilization of CRC screening tests among people 45 years or older in different countries around the globe. PubMed/Medline, Web of Science, and Embase electronic databases were screened for eligible studies from inception to June 30, 2024. The study protocol was registered with international prospective register of systematic reviews (PROSPERO) (CRD42023391344).
A total of 50 studies, based on nationally-representative data, were finally included - 27 from the United States (US) and 23 from other countries. The overall utilization of CRC screening has steadily increased over time in many countries, reaching 74.9% in Denmark in 2018-2020, 64% in Korea in 2020, and 72% in the US in 2021. Nevertheless, the utilization rates remain far below the national or continental targets in most countries. In contrast to European and Asian countries, where screening was predominantly fecal test-based, the approach in the US was primarily driven by colonoscopy, and the uptake of fecal tests and sigmoidoscopy gradually declined in the past two decades.
Despite ongoing progress in CRC screening offers and utilization, there remains large potential for enhanced roll-out and utilization of effective CRC screening programs for enhanced control of CRC incidence and mortality in the years ahead.
There was no funding source for this study.
结直肠癌（CRC）在全球造成的负担巨大且不断增加，这凸显了加强有效CRC筛查措施的实施和利用的紧迫性。因此，我们研究了不同国家CRC筛查测试的终生使用情况和最新使用情况，并描述了随时间推移的利用趋势。
我们对全球不同国家45岁及以上人群中CRC筛查测试的使用程度和近期趋势进行了系统评价。从创刊至2024年6月30日，我们在PubMed/Medline、Web of Science和Embase电子数据库中筛选符合条件的研究。该研究方案已在国际系统评价前瞻性注册库（PROSPERO）注册（CRD42023391344）。
最终纳入了50项基于全国代表性数据的研究，其中27项来自美国，23项来自其他国家。随着时间的推移，许多国家CRC筛查的总体利用率稳步上升，2018 - 2020年丹麦的利用率达到74.9%，2020年韩国为64%，2021年美国为72%。然而，在大多数国家，利用率仍远低于国家或大陆目标。与主要以粪便检测为基础进行筛查的欧洲和亚洲国家不同，美国的筛查方法主要由结肠镜检查推动，在过去二十年中，粪便检测和乙状结肠镜检查的接受率逐渐下降。
尽管CRC筛查措施和利用方面不断取得进展，但在未来几年，为加强对CRC发病率和死亡率的控制，有效CRC筛查项目的推广和利用仍有很大提升潜力。
本研究无资金来源。
