Current status and future perspectives on early detection and diagnosis of colorectal cancer in China

2025-02-26

(Press-News.org)

Colorectal cancer (CRC) is the second most commonly diagnosed cancer in China and a leading cause of cancer-related mortality. Despite improvements in treatment, the survival rate remains lower than in Western and other Asian countries due to late-stage diagnosis. Given that CRC typically develops over a prolonged period from precursor lesions, early detection and timely intervention are crucial for improving patient outcomes. However, CRC screening in China faces several challenges, including regional disparities, economic constraints, and limited public awareness. Recent advancements in non-invasive diagnostic tests, innovative imaging techniques, and artificial intelligence (AI) applications have contributed to enhanced CRC detection and diagnosis. This review provides an overview of CRC screening in China, highlighting existing screening strategies, emerging technologies, and potential future directions.

Current Status of CRC Screening in China

Unlike many developed nations, China does not have a nationwide, organized CRC screening program. Instead, screening is available through government-funded initiatives such as the Cancer Screening Program in Rural China (CanSPRC) and the Cancer Screening Program in Urban China (CanSPUC). In addition, some major cities and provinces have established localized screening programs. The primary screening tools used in these programs include questionnaire-based risk assessments, fecal immunochemical tests (FIT), and colonoscopy for high-risk individuals. However, the overall screening coverage remains low, largely due to socioeconomic barriers and healthcare resource limitations. Expanding CRC screening accessibility and promoting public awareness remain key challenges.

Screening Techniques for CRC in China

CRC screening methods can be categorized as non-invasive and invasive. Each technique has advantages and limitations in terms of sensitivity, specificity, and feasibility.

Fecal Immunochemical Test (FIT)

FIT is a widely used non-invasive screening tool that detects human hemoglobin in stool samples. Compared to traditional guaiac-based tests, FIT has improved specificity and is unaffected by dietary factors. Large-scale studies have demonstrated that FIT-based screening programs significantly reduce CRC incidence and mortality. However, FIT has limited sensitivity for detecting precancerous adenomas, and compliance with follow-up colonoscopy after a positive test result remains suboptimal.

Multitarget Stool DNA (mts-DNA) Test

The mts-DNA test combines stool-based DNA analysis with hemoglobin detection, enhancing CRC sensitivity. While mts-DNA testing has shown higher sensitivity for CRC than FIT, its specificity for adenomas is lower. High costs and complex stool collection procedures have limited its widespread implementation in China.

Colonoscopy

Colonoscopy remains the gold standard for CRC screening and diagnosis, offering direct visualization and removal of precancerous lesions. However, financial constraints, lack of specialized personnel, and concerns about discomfort contribute to low adherence rates. Studies suggest that combining FIT with colonoscopy may enhance participation while optimizing resource utilization.

Blood-Based Biomarkers

Blood-based tests for CRC detection, such as circulating tumor DNA and DNA methylation markers, are under investigation. While promising, these methods currently lack sufficient large-scale validation for routine screening use. Ongoing research may establish blood biomarkers as a cost-effective, non-invasive alternative to stool-based tests.

Other Emerging CRC Screening Methods

Additional CRC screening modalities include flexible sigmoidoscopy, colon capsule endoscopy, and computed tomography (CT) colonography. While these techniques offer advantages such as reduced invasiveness, limitations such as cost, technical complexity, and radiation exposure hinder their widespread adoption in China.

The Role of Artificial Intelligence in CRC Screening

AI has shown great potential in enhancing CRC screening and diagnosis. AI-assisted colonoscopy using computer-aided detection (CADe) systems improves lesion detection rates by compensating for human oversight. Additionally, AI-based computer-aided characterization (CADx) systems facilitate real-time polyp assessment, reducing unnecessary biopsies. Automated quality control systems have also been developed to optimize colonoscopy performance. Despite these advances, challenges such as regulatory frameworks, integration into clinical practice, and cost-effectiveness analysis must be addressed.

Challenges and Future Perspectives

The lack of a nationwide CRC screening program remains a major barrier to early detection efforts in China. Expanding screening coverage, increasing public awareness, and improving follow-up adherence are critical priorities. Financial constraints and disparities in healthcare access further hinder widespread implementation. Future research should focus on optimizing cost-effective screening strategies, particularly for high-risk populations, and integrating emerging technologies such as AI and novel biomarker-based diagnostics.

Limitations

This review primarily focuses on available screening methods rather than a cost-effectiveness analysis. Additionally, while novel technologies present promising supplementary screening options, further real-world studies are needed to assess their practical impact. The perspectives of screening participants, particularly regarding adherence and preferences, warrant further investigation.

Conclusions

Despite ongoing challenges, CRC screening in China has made significant progress. A multifaceted approach involving improved screening programs, advanced diagnostic techniques, and AI-assisted tools will be essential for enhancing early CRC detection. Future studies should focus on refining screening strategies, increasing accessibility, and evaluating the long-term impact of novel technologies on CRC prevention.

Full text

https://www.xiahepublishing.com/2835-3315/CSP-2024-00023

The study was recently published in the Cancer Screening and Prevention.

Cancer Screening and Prevention (CSP) publishes high-quality research and review articles related to cancer screening and prevention. It aims to provide a platform for studies that develop innovative and creative strategies and precise models for screening, early detection, and prevention of various cancers. Studies on the integration of precision cancer prevention multiomics where cancer screening, early detection and prevention regimens can precisely reflect the risk of cancer from dissected genomic and environmental parameters are particularly welcome.

ELSE PRESS RELEASES FROM THIS DATE:

Program’s expansion boosts student research opportunities

2025-02-26

Aerospace engineering senior Philip Wilson attended an American Institute of Aeronautics and Astronautics (AIAA) conference. Rohit Raut, a senior physics major, presented his work at a nuclear research symposium, and senior biology major Jaden Rankin had the opportunity to feature her research at an entomology conference. These and other University of Texas at Arlington students were able to showcase their original research at major symposiums thanks to UTA’s expansion of its popular undergraduate research program that provides funding for select students to present at academic conferences. “At the conference, I presented my work on rotating ...

Deep learning in the diagnosis and prognosis of oral potentially malignant disorders

2025-02-26

Oral cancer remains a serious global health concern due to its high morbidity and mortality rates, primarily caused by late-stage diagnosis. The presence of oral potentially malignant disorders (OPMDs) provides an opportunity for early intervention, as these lesions precede the development of oral squamous cell carcinoma. However, the accurate detection and classification of OPMDs remain challenging due to their diverse clinical presentations. Conventional diagnostic methods, including visual examination and histopathological ...

Some fuel lodges in the inner walls of fusion vessels. Researchers now have a better idea of how much.

2025-02-26

To develop a practical fusion power system, scientists need to fully understand how the plasma fuel interacts with its surroundings. The plasma is superheated, which means some of the atoms involved can strike the wall of the fusion vessel and become embedded. To keep the system working efficiently, it’s important to know how much fuel might be trapped. “The less fuel is trapped in the wall, the less radioactive material builds up,” said Shota Abe, a staff research physicist at the U.S. Department of Energy’s (DOE) Princeton Plasma Physics Laboratory (PPPL). Abe is the lead researcher on a new study published in Nuclear ...

Bismuth-based catalysts: Promising candidates for electrochemical CO2 reduction to formate

2025-02-26

The electrochemical reduction of CO2 has been recognized as a promising strategy to convert ambient atmospheric CO2 into valuable products. Bismuth-based catalysts have garnered the widespread attention of researchers due to their cost-effectiveness, low toxicity, and high natural abundance. Significant progress has been made toward enhancing the reactivity of catalyst structures through innovative synthesis techniques and engineering. Advances include the use of flow cells and membrane electrode assembly (MEA) cells to attain high cathodic current densities of over 200 mA cm-2 with superior ...

Novel molten metal catalysts for CO2-free hydrogen production

2025-02-26

Researchers in South Korea have developed an advanced liquid metal catalyst incorporating selenium (Se) to enhance the efficiency of turquoise hydrogen production. Turquoise hydrogen is generated via methane (CH₄) pyrolysis, producing hydrogen while yielding solid carbon as a byproduct, without emitting carbon dioxide (CO₂). A research team led by Dr. Seung Ju Han at the Korea Research Institute of Chemical Technology (KRICT) has introduced selenium-doped molten metal catalysts (NiBi, CuBi) to significantly enhance methane pyrolysis efficiency. The technology demonstrates ...

Beyond the burn: Harvesting dead wood to reduce wildfires and store carbon

2025-02-26

A century of fire suppression, combined with global warming and drought, has led to increasingly destructive wildfires in the Western United States. Forest managers use tools like prescribed burns, thinning, mastication, and piling and burning to reduce fuel – live and dead trees, needles and leaves, and downed branches – that can feed intense wildfires. These methods aim to lower fuel levels, reduce crown density, and protect fire-resistant trees, fostering healthier, more resilient forests. However, prescribed burning efforts haven’t kept up with the rapid buildup of surface fuel, creating a “fire deficit” – the gap between the amount of fuel that has ...

Researchers at Case Western Reserve, University Hospitals to begin clinical testing with new, less-invasive technology to screen for esophageal precancer

2025-02-26

CLEVELAND—Researchers at Case Western Reserve University (CWRU) and University Hospitals (UH) will use state-of-the-art medical technologies they invented—and licensed to Lucid Diagnostics Inc.—to detect esophageal precancer, specifically Barrett’s Esophagus (BE). BE is a change in the cellular structure of the esophageal lining typically caused by gastroesophageal reflux disease (GERD), also known as heartburn. The goal is to reduce the incidence of esophageal cancer (EAC). EAC is a rare type of cancer with a high-morality rate—the cause of 2.6% of all cancer ...

JMC｜With generative AI assistance, Insilico Medicine announces novel CDK12/13 dual inhibitors for tumor treatment

2025-02-26

Insilico Medicine ("Insilico"), a clinical stage generative artificial intelligence (AI)-driven biotechnology company, today announced the publication of a novel series of orally available covalent CDK12/13 dual inhibitors, as a potential option against refractory and treatment-resistant cancers. Published in the Journal of Medicinal Chemistry (IF=7.2), the study showcases the discovery of compound 12b, a potent, selective, and safe therapy targeting CDK12/13, empowered by Insilico’s proprietary generative AI platforms including PandaOmics and ...

Novel photochromic glass can store rewritable 3D patterns

2025-02-26

For decades researchers have been exploring how to store data in glass because of its potential to hold information for a long time — eons — without applying power. A special type of glass that changes color in different wavelengths of light, called photochromic glass, holds promise for stable, reusable data storage. Now, researchers have developed a doped photochromic glass that has the potential to store rewritable data indefinitely, according to research published in ACS Energy Letters. Certain types of ...

Sea sponge inspires super strong compressible material

2025-02-26

Inspired by the humble deep-sea sponge, RMIT University engineers have developed a new material with remarkable compressive strength and stiffness that could improve architectural and product designs. The double lattice design was inspired by the intricate skeleton of a deep-sea sponge known as Venus' flower basket, which lives in the Pacific Ocean. Lead author of the latest RMIT study into the structure, Dr Jiaming Ma, said extensive testing and optimisation revealed the pattern's impressive combination of stiffness and strength, mixed with an ability to contract when compressed. It’s this last aspect – known as auxetic behaviour – ...

Inhibition of cyclooxygenase-2 upregulates the nuclear factor erythroid 2-related factor 2 signaling pathway to mitigate hepatocyte ferroptosis in chronic liver injury

Current status and future perspectives on early detection and diagnosis of colorectal cancer in China

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: