Chen Yuqing, Zhang Yuelun, Yan Yike, Han Jingjing, Zhang Li, Cheng Xinran, Lu Bin, Li Na, Luo Chenyu, Zhou Yueyang, Song Kai, Iwasaki Motoki, Dai Min, Wu Dong, Chen Hongda
Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
J Transl Med. 2025 Jul 22;23(1):811. doi: 10.1186/s12967-025-06887-4.
Screening is effective in reducing the disease burden of colorectal cancer, with participation and coverage rates being key determinants of its effectiveness. This systematic review aims to provide a comprehensive assessment of colorectal cancer screening program characteristics and global screening coverage rates. We conducted a systematic literature search in the PubMed and Embase databases from inception to March 2025. Grey literature was obtained from screening program websites and relevant reports. Studies reporting nationwide colorectal cancer screening coverage were eligible for our analysis. A comprehensive overview of essential information and the most recent coverage rates for global screening programs were reported. Temporal trend analyses of coverage rates and subgroup analyses by sex and age were performed. Our results encompassed 45 countries with established national screening programs, among which 33 of them having retrieved coverage rates. Population-based screening programs were predominantly conducted in Europe (25/39), with fecal occult blood testing being the most commonly used modality (38/39). The reported latest screening coverage rates varied greatly across countries, ranging from 1.0% (China, 2020) to 79.4% (Finland, 2021). The coverage of screening program differed slightly between men and women in most countries (men: IQR, 25.3-52.7%; women: IQR, 23.0-65.1%), and coverage increased with age. Temporal trend analysis in 14 countries showed that the majority exhibited increasing or stable screening coverage rates. These findings highlight significant disparities in CRC screening implementation worldwide. Targeted efforts to improve participation and expand coverage are essential, particularly in countries with a high disease burden.
筛查在降低结直肠癌疾病负担方面是有效的，参与率和覆盖率是其有效性的关键决定因素。本系统评价旨在全面评估结直肠癌筛查项目的特征和全球筛查覆盖率。我们在PubMed和Embase数据库中进行了从建库至2025年3月的系统文献检索。通过筛查项目网站和相关报告获取灰色文献。报告全国结直肠癌筛查覆盖率的研究符合我们的分析标准。报告了全球筛查项目基本信息和最新覆盖率的全面概述。进行了覆盖率的时间趋势分析以及按性别和年龄的亚组分析。我们的结果涵盖了45个已建立国家筛查项目的国家，其中33个国家检索到了覆盖率。基于人群的筛查项目主要在欧洲开展（25/39），粪便潜血试验是最常用的方式（38/39）。各国报告的最新筛查覆盖率差异很大，从1.0%（中国，2020年）到79.4%（芬兰，2021年）。在大多数国家，筛查项目的覆盖率在男性和女性之间略有差异（男性：四分位间距，25.3 - 52.7%；女性：四分位间距，23.0 - 65.1%），且覆盖率随年龄增长而增加。14个国家的时间趋势分析表明，大多数国家的筛查覆盖率呈上升或稳定趋势。这些发现凸显了全球结直肠癌筛查实施情况的显著差异。有针对性地努力提高参与率和扩大覆盖率至关重要，特别是在疾病负担较高的国家。
