Wu YP, Chen M, Wang L. Current colorectal cancer screening in developing countries: Identifying optimal approaches. World J Gastroenterol 2026; 32(26): 118151 [DOI: 10.3748/wjg.118151]
Corresponding Author of This Article
Min Chen, Professor, Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, No. 321 Zhongshan Road, Nanjing 210093, Jiangsu Province, China. croweminchan@nju.edu.cn
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Oncology
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review-article
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Wu YP, Chen M, Wang L. Current colorectal cancer screening in developing countries: Identifying optimal approaches. World J Gastroenterol 2026; 32(26): 118151 [DOI: 10.3748/wjg.118151]
World J Gastroenterol. Jul 14, 2026; 32(26): 118151 Published online Jul 14, 2026. doi: 10.3748/wjg.118151
Current colorectal cancer screening in developing countries: Identifying optimal approaches
Yan-Ping Wu, Min Chen, Lei Wang
Yan-Ping Wu, Min Chen, Lei Wang, Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, Nanjing 210093, Jiangsu Province, China
Co-corresponding authors: Min Chen and Lei Wang.
Author contributions: Wu YP is responsible for the conception and writing; Chen M is responsible for the supervision; Wang L provided supervision, administrative support, and final approval of the manuscript. Chen M and Wang L are designated as co-corresponding authors.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Corresponding author: Min Chen, Professor, Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, No. 321 Zhongshan Road, Nanjing 210093, Jiangsu Province, China. croweminchan@nju.edu.cn
Received: December 26, 2025 Revised: January 30, 2026 Accepted: April 8, 2026 Published online: July 14, 2026 Processing time: 185 Days and 10.5 Hours
Abstract
Colorectal cancer (CRC) screening has proven effective in reducing cancer-related mortality through early detection. Emerging epidemiological patterns, particularly the rising incidence of early-onset CRC and aging, call for changes for current inadequate CRC screening programs in developing countries. The benefits of CRC screening have come out in developed countries, while more prevailing environmental risk factors coupled with a gap in CRC screening implementation are observed in developing countries. Conventional screening modalities like fecal immunochemical tests are more acceptable, but lack sensitivity for advanced adenomas. Authoritative colonoscopy manifests high efficacy but suffers from poor adherence. Meanwhile, novel screening modalities require optimization. Comparatively high-adherence non-invasive tools could sort high-risk sets for colonoscopy. Growing evidence highlights the potential role of risk stratification approach beyond conventional age, which may refine colonoscopy referral. And microsimulation modeling is valuable for optimizing and evaluating screening strategies before and after screening. It suggests that an adaptive and organized screening framework may offer optimal population-level benefits.
Core Tip: Socioeconomic transition and associated shifts toward unhealthy lifestyles are reshaping the global epidemiology of colorectal cancer. While many developed nations have benefited from healthier lifestyle adoption and screening implementation, numerous developing countries now face a rising burden of risk factors alongside scare screening programs. We herein discussed related factors and potential frameworks for implementing effective colorectal cancer screening in developing countries.
