ASPO Abstracts
Colorectal Cancer Screening Practices and Screening Rates in Asian Countries: A Systematic Literature Review
Category: Global Cancer Research
Conference Year: 2019
Abstract Body:
Purpose: Currently, there is a paucity of research on colorectal cancer (CRC) screening in Asian countries. We conducted a systematic literature review assessing CRC screening practices and CRC screening uptake rates in Asian countries to address this gap in knowledge. Methods: An electronic systematic literature search within PubMed (MEDLINE), the Cochrane Library, and EMBASE was conducted to identify articles related to CRC screening and prevalence among asymptomatic, average risk adults aged 40 to 75 years living within Asian countries. All results were de-duplicated within EndNote and screened within Covidence. Articles were identified using keywords and controlled vocabulary. No restrictions on language, date of publication, or any other filters were used when searching the electronic databases to maximize articles obtained. All documentation related to the literature search and data extraction was formulated using PRISMA guidelines. Results: High variability was observed in the primary screening methods used across different Asian countries (N = 10). The most frequently used screening modality was fecal occult blood test (FOBT), followed by fecal immunochemical test (FIT) and colonoscopy. Less frequently used CRC screening modalities were: barium enema, endoscopy, and digital rectal exam (DRE). Nationwide (NW) estimates compared to either study-specific or sub-population (SSP) CRC screening rates by country were extremely variable: China NW: 11.01% vs. SSP: 12%—97.7%, Hong Kong NW: 9.9%—19% vs. SSP: 27%—68.4%, Japan NW: 12%—64.4% vs. SSP:15.7%—84.5%, Korea NW: 10.5%—55.6% vs. SSP: 21.3%—36.7%, Singapore NW: 3.8%—74.7% vs. SSP: 3.8%—19%, and Taiwan NW: 21.4%—87% vs. SSP: 61.9%. Other Asian countries reported only one screening rate: Brunei Darussala SSP: 63.6%, Georgia SSP: 1,368 screened, Malaysia SSP: 0.7%—90.8%, and Thailand NW: 62.9%. Conclusions: CRC screening practices in Asian countries favored use of FOBT, FIT, and colonoscopy. The systematic literature review revealed variability in CRC screening uptake both within and between the ten Asian countries, which may impact CRC incidence and mortality rates. To improve CRC outcomes in Asian countries, policies to support and fund programs that work to increase screening uptake rates are needed.
Keywords: Colorectal Cancer, Screening, Asian Countries