Asia Pacific consensus recommendations for colorectal cancer screening

Abstract

Colorectal cancer (CRC) is rapidly increasing in Asia, but screening guidelines are lacking. Through reviewing the literature and regional data, and using the modified Delphi process, the Asia Pacific Working Group on Colorectal Cancer and international experts launch consensus recommendations aiming to improve the awareness of healthcare providers of the changing epidemiology and screening tests available. The incidence, anatomical distribution and mortality of CRC among Asian populations are not different compared with Western countries. There is a trend of proximal migration of colonic polyps. Flat or depressed lesions are not uncommon. Screening for CRC should be started at the age of 50 years. Male gender, smoking, obesity and family history are risk factors for colorectal neoplasia. Faecal occult blood test (FOBT, guaiac-based and immunochemical tests), flexible sigmoidoscopy and colonoscopy are recommended for CRC screening. Double-contrast barium enema and CT colonography are not preferred. In resource-limited countries, FOBT is the first choice for CRC screening. Polyps 5-9 mm in diameter should be removed endoscopically and, following a negative colonoscopy, a repeat examination should be performed in 10 years. Screening for CRC should be a national health priority in most Asian countries. Studies on barriers to CRC screening, education for the public and engagement of primary care physicians should be undertaken. There is no consensus on whether nurses should be trained to perform endoscopic procedures for screening of colorectal neoplasia.

S3-Leitlinie – Kolorektales Karzinom

“…Zum einen die Empfehlungen der US Preventive Task Force aus dem Jahr 2008 [95] und zum anderen die Asian Pacific consensus recommendations aus dem Jahr 2007 [187]. Von der US-Preventive Task Force werden die folgenden Methoden empfohlen: ein sensitiver FOBT (aufgeführt Hämoccult sensa ® und IFOBT/FIT) jährlich, eine Sigmoidoskopie alle 5 Jahre zusammen mit einem FOBT alle 3 Jahre oder eine Koloskopie alle 10 Jahre.…”

Participation and Barriers to Colorectal Cancer Screening in Malaysia

“…In the Asian region, The Asia Pacific Consensus recommends screening for colorectal cancer from the age of 50 years (Sung et al, 2008). In Malaysia, guidelines on screening for colorectal cancer were introduced in 2001 (Malaysian Society of Gastroenterology & Hepatology, 2001).…”

Increasing uptake of colorectal cancer screening in Korea: a population-based study

“…Although the incidence of CRC is increasing rapidly in Asian countries, national guidelines for CRC screening are nonexistent in most Asian countries [12]. Recently, the Asia Pacific Working Group on Colorectal Cancer reached a consensus to develop guidelines for CRC screening and recommend FOBT, FISG, and colonoscopy as the best options [13]. …”