J Korean Med Assoc.  2015 May;58(5):420-432. 10.5124/jkma.2015.58.5.420.

The Korean guideline for colorectal cancer screening

• Sohn DK
• Kim MJ
• Park Y
• Suh M
• Shin A
• Lee HY
• Im JP
• Cho HM
• Hong SP
• Kim BH
• Kim Y
• Kim JW
• Kim HS
• Nam CM
• Park DI
• Um JW
• Oh SN
• Lim HS
• Chang HJ
• Hahm SK
• Chung JH
• Kim SY
• Kim Y
• Lee WC
• Jeong SY

• KMID: 2195038
• DOI: http://doi.org/10.5124/jkma.2015.58.5.420

Abstract

Colorectal cancer is the third most common cancer in Korea; it is the second most common cancer in men and the third most common in women. The incidence rate in Korea has continuously increased since 1999 when the National Cancer Registry statistics began. Currently; there are several screening modalities; that have been recommended by expert societies, including fecal occult blood test, colonoscopy, computed tomographic colonography The annual fecal immunochemical test (FIT) has been used in adults aged 50 and older as part of the National Cancer Screening Program in Korea since 2004. Although several study results from regional or national colorectal cancer screening programs in other countries have been reported, the National Cancer Screening Program in Korea has not yet been evaluated with evidence-based methods. Herein report the consensus statements on the National Screening Guideline for colorectal cancer developed by a multi-society expert committee in Korea, as follows: 1) We recommend annual or biennial FIT for screening for colorectal cancer in asymptomatic adults, beginning at 45 years of age and continuing until 80 years (recommendation B). 2) There is no evidence for the risks or benefits of FIT in adults older than 80 years (recommendation I). 3) Selective use of colonoscopy for colorectal cancer screening is recommended, taking into consideration individual preference and the risk of colorectal cancer (recommendation C). 4) There is no evidence for the risks or benefits of double-contrast barium enema for colorectal cancer screening in asymptomatic adults (recommendation I). 5) There is no evidence for the risks or benefits of computed tomographic colonography for colorectal cancer screening in asymptomatic adults (recommendation I).

Keyword

Early detection of cancer; Colorectal neoplasms; Occult blood; Colonoscopy; Computed tomographic colonography

MeSH Terms

Adult
Barium
Colonography, Computed Tomographic
Colonoscopy
Colorectal Neoplasms*
Consensus
Early Detection of Cancer
Enema
Female
Humans
Incidence
Korea
Male
Mass Screening*
Occult Blood
Barium

Figure

• 

  Figure 1 Framework of developing a guideline for colorectal cancer screening. Key question 1, Is there enough evidence of screening benefit?; Key question 2, What is the optimal screening interval?; Key question 3, What is the optimal age to start and stop screening?; Key question 4, What is the incidence of harms of screening? Screening: colonoscopy, fecal occult blood test, double-contrast barium enema, and CT colonoscopy. FIT, Fecal Immunochemical Test; DOBE, double contrast barium enema; CT, computed tomography.

• 

  Figure 2 Flow of searching literatures for evidence of colonoscopy, FOBT, DCBE, CT colonoscopy. A, Flowchart of colonoscopy selection. B, Flowchart of FOBT selection C, Flowchart of DCBE selection. D, Flowchart of CT colonoscopy selection.

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