Development of a New Model for Colorectal Cancer Screening

Colorectal cancer is the third most common cancer in Europe and the second most common cause of cancer death. Early detection and diagnosis of colorectal cancer are especially critical for increasing the survival rate.

Currently, colorectal cancer screening methods contribute to poor participant compliance. Screening approaches are divided into two categories – non-invasive and invasive – and usually target people aged 50–74. In most countries that use the faecal occult blood test (FOBT), screening is available every two years. With colonoscopy and flexible sigmoidoscopy, the screening schedule is less frequent, typically every 10 years. Invasive methods, such as colonoscopy, remain the main screening tools thanks to their excellent diagnostic performance. However, they require lengthy preparation and are a cause of discomfort to patients.

A healthy lifestyle and physical exercise can reduce the risk of developing colorectal cancer, but there is also a recognised hereditary component. Studies have shown that polygenic risk scores may lead to recommendations for personalised screening, using the faecal occult blood test and colonoscopy, for high-risk individuals in age groups significantly younger than current recommendations do.

We are moving towards the development of an efficient approach to enhance patient compliance that can be applied to screening the general population. Our design for individualised colorectal cancer screening is based on personal risk and implements a combination of polygenic risk score, disease-associated gene variations and lifestyle risk factors.