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CC BY-NC-ND 4.0 · South Asian J Cancer 2024; 13(04): 229-235
DOI: 10.1055/s-0045-1802655
Original Article
Screening

Screening for Colorectal Carcinoma in India: Real-World Scenario, Pitfalls, and Solutions

Mansi Agrawal
1   Medical Student, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India
,
Adwaith Krishna Surendran
2   Medical Student, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Karthik Kanna Venkatesh
2   Medical Student, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Praveen Nandha Kumar Pitchan Velammal
3   Medical Student, Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India
,
Sarvesh Zope
4   All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
,
Anika Goel
5   Medical Student, Kakatiya Medical College, Warangal, Telangana, India
,
Aarnav Pathak
6   Medical Student, ShriAtalBihari Vajpayee Medical College and Research Institute, Bengaluru, Karnataka, India
,
Mallika Mittal
7   Medical Student, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
,
Varshitha K.K
8   Medical Student, Madras Medical College, Chennai, Tamil Nadu, India
,
Archana Sameer Vinakar
9   Medical Officer E, Tata Institute of Fundamental Research, National Centre of Government of India, Dept of Atomic Energy, Colaba, Mumbai, Maharashtra, India
,
Daksh Agrawal
10   Medical Intern, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India
,
Purvish M. Parikh
11   Department of Clinical Hematology, Sri Ram Cancer Center, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India
› Institutsangaben
Funding None.
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Abstract

Introduction

Noninvasive colorectal cancer (CRC) screening has introduced innovative blood- and stool-based biomarkers, improving early detection and enabling personalized solutions. Global and Indian adoption of CRC screening remains a public health challenge. This study evaluates the real-world utility of screening colonoscopy, as recommended by global guidelines.

Methodology

A survey based on the American Medical Association (AMA) guidelines was designed, setting 45+ years as the cutoff age for colonoscopy screening. A Google form was shared via social media application with health care professionals. Participation was voluntary, responses were collected over 30 days, and data were analyzed.

Results

A total of 2,199 individuals' data were analyzed. Among these, 1,374 were eligible for screening colonoscopy, out of which only 7.14% (98/1,374) actually underwent the procedure.

Conclusion

Among various cancer programs, screening sigmoidoscopy has proved to improve both CRC-specific mortality and all-cause mortality. Unfortunately, its utilization is suboptimal, at best. Even among the highly educated medical community, the real-world utility was only in 7.14% of the eligible population. Barriers include invasive nature of intervention, need for appropriate bowel preparation, operator dependence, and small but significant risk of serious toxicity. An important method of increasing utility of screening colonoscopy is use of a test that can identify high-risk population, who can then be persuaded to undergo screening colonoscopy. This is the value of recently developed noninvasive blood- and stool-based tests, like Guardant Health's Shield. Being U.S. Food and Drug Administration (FDA) approved with specificity of 90% and sensitivity of 84%, it should be offered to all eligible persons who can afford it, thereby increasing colonoscopy use and potentially saving lives.

Keywords

early detection - liquid biopsy - microbiome - cancer mortality - public health

Note

An important disclaimer is that our work and this manuscript are NOT for individuals at risk of hereditary CRC/hereditary syndromes, where the American Society of Clinical Oncology (ASCO) recommendations for genetic screening can be followed.




Publikationsverlauf

Artikel online veröffentlicht:
12. Februar 2025

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