A Working Group of 23 independent experts from 15 countries, convened by the International Agency for Research on Cancer (IARC) in November 2017, reviewed the scientific evidence and assessed the cancer-preventive and adverse effects of various methods of screening for colorectal cancer. Colorectal cancer is the third most common cancer in men and the second most common in women worldwide, and represents more than 10% of the global cancer burden.

This publication provides evidence-based evaluations of the effectiveness of colorectal cancer screening in reducing colorectal cancer incidence and mortality. The Working Group also reviewed the body of evidence on the comparison of endoscopic and stool-based techniques, on the determinants of participation in screening programmes, and on the most mature emerging techniques that may be alternatives to current practices for colorectal cancer screening, as well as presenting the different categories of high-risk populations and the surveillance strategies for such individuals.

Contents

• Note to the Reader
• List of Participants
• Working Procedures
• General Remarks
• List of Abbreviations
• Glossary
• 1. COLORECTAL CANCER
  • 1.1. Global burden: incidence, mortality, survival, and projections
  • 1.2. Classification and natural history
  • 1.3. Stage at diagnosis, survival, and treatment
  • 1.4. Risk factors and protective factors
  • References
• 2. AVAILABILITY AND USE OF COLORECTAL CANCER SCREENING
  • 2.1. Europe
  • 2.2. Canada and the USA
  • 2.3. Latin America
  • 2.4. Africa
  • 2.5. Central, West, and South Asia
  • 2.6. East and South-East Asia
  • 2.7. Oceania
  • References
• 3. STUDIES OF COLORECTAL CANCER SCREENING
  • 3.1. Methodological considerations
  • 3.2. Stool-based tests for blood
  • 3.3. Endoscopic methods
  • 3.4. Comparison of preventive effects of endoscopic methods and stool-based tests for blood
  • 3.5. Computed tomography colonography
  • 3.6. Participation in screening for colorectal cancer
  • 3.7. Emerging techniques
  • 3.8. Populations at high risk of colorectal cancer
• 4. SUMMARY
  • 4.1. Colorectal cancer
  • 4.2. Colorectal cancer screening worldwide
  • 4.3. Stool-based tests for blood
  • 4.4. Endoscopic methods
  • 4.5. Comparison of the preventive effects of endoscopic methods and stool-based tests for blood
  • 4.6. Computed tomography colonography
  • 4.7. Participation in screening for colorectal cancer
  • 4.8. Emerging techniques
  • 4.9. Populations at high risk of colorectal cancer
• 5. EVALUATION
  • 5.1. Guaiac faecal occult blood test
  • 5.2. Faecal immunochemical test
  • 5.3. Flexible sigmoidoscopy
  • 5.4. Colonoscopy
  • 5.5. Computed tomography colonography

This publication represents the views and expert opinions of an IARC Working Group on the Evaluation of Cancer-Preventive Interventions, which met in Lyon, 14–21 November 2017

Lyon, France - 2019

IARC Handbooks of Cancer Prevention

In 1969, the International Agency for Research on Cancer (IARC) initiated a programme on the evaluation of the carcinogenic risk of chemicals to humans involving the production of critically evaluated monographs on individual chemicals.

The IARC Handbooks of Cancer Prevention complement the IARC Monographs’ evaluations of carcinogenic hazards. The objective of the programme is to produce and publish a series of critical reviews of data on the cancer-preventive effects of primary or secondary interventions, to evaluate these data in terms of cancer prevention with the help of international working groups of experts in prevention and related fields, and to indicate where additional research efforts are needed. The lists of evaluations are regularly updated and are available at http://handbooks.iarc.fr/.

This IARC Handbook of Cancer Prevention is partly funded by the American Cancer Society (contract ACS #26531) and by the Grant or Cooperative Agreement Number DP004954-05, funded by the United States Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

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• ©International Agency for Research on Cancer, 2019
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  Corrigenda to IARC Handbook 17. (PDF, 84K)

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International Agency for Research on Cancer

The International Agency for Research on Cancer (IARC) was established in 1965 by the World Health Assembly, as an independently funded organization within the framework of the World Health Organization. The headquarters of the Agency are in Lyon, France.

The Agency has as its mission to reduce the cancer burden worldwide through promoting international collaboration in research. The Agency addresses this mission through conducting cancer research for cancer prevention in three main areas: describing the occurrence of cancer; identifying the causes of cancer, and evaluating preventive interventions and their implementation. Each of these areas is a vital contribution to the spectrum of cancer prevention.

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