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Third Asia-Pacific consensus recommendations on colorectal cancer screening and postpolypectomy surveillance
  1. Joseph J Y Sung1,
  2. Han-Mo Chiu2,3,
  3. David Lieberman4,
  4. Ernst J Kuipers5,
  5. Matthew D Rutter6,
  6. Finlay Macrae7,
  7. Khay-Guan Yeoh8,
  8. Tiing Leong Ang9,
  9. Vui Heng Chong10,
  10. Sneha John11,
  11. Jingnan Li12,
  12. Kaichun Wu13,
  13. Simon S M Ng14,
  14. Govind K Makharia15,
  15. Murdani Abdullah16,17,
  16. Nozomu Kobayashi18,19,
  17. Masau Sekiguchi18,19,
  18. Jeong-Sik Byeon20,
  19. Hyun-Soo Kim21,
  20. Susan Parry22,23,
  21. Patricia Anne I Cabral-Prodigalidad24,
  22. Deng-Chyang Wu25,
  23. Suparkij Khomvilai26,
  24. Rashid N Lui27,28,
  25. Sunny Wong1,
  26. Yu-Min Lin29,
  27. E Dekker30
  1. 1 Lee Kong Chian School of Medicine, Singapore
  2. 2 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  3. 3 Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
  4. 4 Oregon Health and Science University, Portland, Oregon, USA
  5. 5 Erasmus MC, Rotterdam, The Netherlands
  6. 6 University Hospital of North Tees, Stockton-on-Tees, UK
  7. 7 The Royal Melbourne Hospital, Melbourne, Victoria, Australia
  8. 8 National University of Singapore, Singapore
  9. 9 Changi General Hospital, SingHealth Group, Singapore
  10. 10 Raja Isteri Pengiran Anak Saleha Hospital, Brunei, Brunei Darussalam
  11. 11 Digestive Health, Endoscopy, Gold Coast University Hospital, Southport, Queensland, Australia
  12. 12 Peking Union Medical College Hospital, Beijing, China
  13. 13 Fourth Military Medical University, Xi'an, China
  14. 14 The Chinese University of Hong Kong, Hong Kong, Hong Kong
  15. 15 All India Institute of Medical Sciences, New Delhi, Delhi, India
  16. 16 Division of Gastroenterology, Pancreatibiliar and Digestive Endoscopy. Department of Internal Medicine, Hospital Dr Cipto Mangunkusumo, Jakarta, Indonesia
  17. 17 Human Cancer Research Center. IMERI. Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  18. 18 Cancer Screening Center/ Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  19. 19 Division of Screening Technology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
  20. 20 University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
  21. 21 Yonsei University, Seoul, Korea (the Republic of)
  22. 22 National Bowel Screening Programme, New Zealand Ministry of Health, Auckland, New Zealand
  23. 23 The University of Auckland, Auckland, New Zealand
  24. 24 St Luke Hospital, Quezon City, Philippines
  25. 25 Kaohsiung Medical University, Kaohsiung, Taiwan
  26. 26 Chulalongkorn University, Bangkok, Thailand
  27. 27 Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, Hong Kong
  28. 28 Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  29. 29 Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan
  30. 30 Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Professor Joseph J Y Sung, Lee Kong Chian School of Medicine, Singapore, Singapore; josephsung{at}


The Asia-Pacific region has the largest number of cases of colorectal cancer (CRC) and one of the highest levels of mortality due to this condition in the world. Since the publishing of two consensus recommendations in 2008 and 2015, significant advancements have been made in our knowledge of epidemiology, pathology and the natural history of the adenoma-carcinoma progression. Based on the most updated epidemiological and clinical studies in this region, considering literature from international studies, and adopting the modified Delphi process, the Asia-Pacific Working Group on Colorectal Cancer Screening has updated and revised their recommendations on (1) screening methods and preferred strategies; (2) age for starting and terminating screening for CRC; (3) screening for individuals with a family history of CRC or advanced adenoma; (4) surveillance for those with adenomas; (5) screening and surveillance for sessile serrated lesions and (6) quality assurance of screening programmes. Thirteen countries/regions in the Asia-Pacific region were represented in this exercise. International advisors from North America and Europe were invited to participate.


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  • JJYS and H-MC are joint first authors.

  • Twitter @RashidLui, @sunnyheiwong

  • Contributors 1. Coordinators (JJYS, H-MC, ED) were responsible for drafting the statements and coordinating the process of discussion and voting on the statements. 2. Advisors (DL, EJK, MDR, FM) helped to draft the first statements, moderate discussion during the meeting and revise the statements accordingly. 3. Panels (K-GY, TLA, VHC, JS, JL, KW, SSMN, GKM, MA, NK, MS, J-SB, H-SK, SP, PAIC-P, D-CW, SK) were country/region representatives who participated in the discussions and voting of the statements during the virtual conference. 4. Facilitators (SW, RNL, Y-ML) were responsible for performing the literature search, collating the discussion points and revising the statements.

  • Funding The authors have not received specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.