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An updated Asia Pacific Consensus Recommendations on colorectal cancer screening
  1. J J Y Sung1,
  2. S C Ng1,2,
  3. F K L Chan1,2,
  4. H M Chiu3,
  5. H S Kim4,
  6. T Matsuda5,
  7. S S M Ng6,
  8. J Y W Lau6,
  9. S Zheng7,
  10. S Adler8,
  11. N Reddy9,
  12. K G Yeoh10,
  13. K K F Tsoi11,
  14. J Y L Ching2,
  15. E J Kuipers12,
  16. L Rabeneck13,
  17. G P Young14,
  18. R J Steele15,
  19. D Lieberman16,
  20. K L Goh17
  1. 1Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
  2. 2Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong
  3. 3Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
  4. 4Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
  5. 5Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  6. 6Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  7. 7Cancer Institute, Zhejiang University, Hanggzhou, Zhejiang, China
  8. 8Division of Gastroenterology, Bikur Holim Hospital, Jerusalem, Israel
  9. 9Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, Andhra Pradesh, India
  10. 10Department of Medicine, Asian Healthcare Foundation, National University of Singapore and Senior Consultant Gastroenterologist, Singapore
  11. 11School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  12. 12Department of Medicine & Therapeutics, Erasmus University Medical Center, Rotterdam, Netherlands
  13. 13Institute of Clinical Evaluative Sciences, University of Toronto, Ontario, Canada
  14. 14Department of Gastroenterology, Flinders Medical Centre, Adelaide, South Australia, Australia
  15. 15Department of Surgery and Molecular Oncology, University of Dundee, Dundee, UK
  16. 16Portland VA Medical Centre, Portland, Oregon, USA
  17. 17Department of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia
  1. Correspondence to Professor Joseph Sung, Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, NT, Hong Kong; jjysung{at}


Objective Since the publication of the first Asia Pacific Consensus on Colorectal Cancer (CRC) in 2008, there are substantial advancements in the science and experience of implementing CRC screening. The Asia Pacific Working Group aimed to provide an updated set of consensus recommendations.

Design Members from 14 Asian regions gathered to seek consensus using other national and international guidelines, and recent relevant literature published from 2008 to 2013. A modified Delphi process was adopted to develop the statements.

Results Age range for CRC screening is defined as 50–75 years. Advancing age, male, family history of CRC, smoking and obesity are confirmed risk factors for CRC and advanced neoplasia. A risk-stratified scoring system is recommended for selecting high-risk patients for colonoscopy. Quantitative faecal immunochemical test (FIT) instead of guaiac-based faecal occult blood test (gFOBT) is preferred for average-risk subjects. Ancillary methods in colonoscopy, with the exception of chromoendoscopy, have not proven to be superior to high-definition white light endoscopy in identifying adenoma. Quality of colonoscopy should be upheld and quality assurance programme should be in place to audit every aspects of CRC screening. Serrated adenoma is recognised as a risk for interval cancer. There is no consensus on the recruitment of trained endoscopy nurses for CRC screening.

Conclusions Based on recent data on CRC screening, an updated list of recommendations on CRC screening is prepared. These consensus statements will further enhance the implementation of CRC screening in the Asia Pacific region.

  • Colorectal Cancer
  • Screening

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