• British medical bulletin · Jan 2013

    Colorectal cancer screening in Asia.

    • Siew C Ng and Sunny H Wong.
    • Prince of Wales Hospital, Shatin, NT, Hong Kong, China. siewchienng@cuhk.edu.hk
    • Br. Med. Bull. 2013 Jan 1; 105: 29-42.

    IntroductionThe incidence and mortality of colorectal cancer are rapidly rising in several countries in Asia. However, screening guidelines are lacking.Sources Of DataReview of literature and local data published in peer review journals.Areas Of AgreementThe incidence, anatomical distribution and mortality of colorectal cancer among Asian populations are comparable to those in Western countries. Flat and depressed colonic lesions are not uncommon. Male gender, smoking, obesity, metabolic syndrome and family history are risk factors for colorectal cancer. Certain ethnic groups in Asia have increased susceptibility to colorectal cancer. Faecal occult blood test, flexible sigmoidoscopy and colonoscopy are recommended options for colorectal cancer screening in Asia. Regular screening should start at the age of 50 years.Areas Of ControversyThe optimal screening method in Asia remains unclear. Faecal immunochemical test has been suggested as the first choice of screening test in countries with limited resources. The role of nurse endoscopists in performing endoscopic procedures for colorectal cancer screening in Asia has not been defined.Growing PointsThere is low public awareness and little support by health authorities for screening and prevention of this emerging disease.Areas Timely For Developing ResearchScreening for colorectal cancer should be a national health priority in most Asian countries. Studies on barriers to screening, education of the public and engagement of family physicians are important strategies in promoting colorectal cancer screening. With more health-care support, increased public acceptance and better access to the general population, colorectal cancer screening in Asia can be rewarding.

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