Formulating effective and accessible population-based colorectal cancer screening programs

Colorectal cancer, a type of carcinoma originating in cells of the colon or rectum, continues to rank as the third most prevalent cancer worldwide with 1.36 million cases and the fourth most fatal with 693,881 deaths during 2012. In an attempt to alleviate the burden of colorectal cancer throughout society, governments and non-governmental organizations continue to implement population-based cancer screening programs. These programs, typically designed by a federal authority, offer free screening tests to a given population for a certain type of cancer on a routine basis. National systematic screening programs have effectively reduced the incidence of and mortality from colorectal cancer in several countries. This paper specifically focuses on programs related to colorectal cancer screening, which offer various types of testing depending on the population. As colorectal cancer screening programs remain primarily nationally-based rather than international, few guidelines have been established relating to the design of systematic colorectal cancer screening programs. This paper first highlights the need for colorectal cancer screening programs, then addresses barriers to individual and national screening, and finally evaluates characteristics and components of successful colorectal programs in the global context with a goal to establish recommended guidelines in designing such programs.