TITLE:
Enhancing Early Detection: An Analysis of Screening Methods for Colorectal Cancer
AUTHORS:
Chisom Goodly Ubah, Yuqiang Shan
KEYWORDS:
Colorectal Cancer (CRC), Cancer Screening, Colonoscopy, Fecal Immunochemical Test (FIT), Stool DNA Testing, Early Detection, Molecular Diagnostics, Health Equity
JOURNAL NAME:
Open Access Library Journal,
Vol.13 No.7,
July
1,
2026
ABSTRACT: Colorectal cancer (CRC) remains a leading cause of cancer-related deaths globally, but its incidence and mortality have significantly decreased with proactive screening. Nevertheless, effective screening methods, such as colonoscopy, stool DNA, and FIT, have not been widely adopted, particularly among marginalized communities. Understanding how to implement these screening methods, the barriers to their utilization, and the potential of new approaches to expand screening is essential. This study aimed to assess the effectiveness of existing CRC screening methods, identify obstacles to their broader use, and evaluate new methods that could enhance early-stage diagnosis rates. A structured narrative literature review was conducted, drawing on peer-reviewed studies, clinical trial reports, and published screening guidelines from PubMed, Scopus, and Web of Science. The evidence was organized thematically around three key areas: the effectiveness of screening methods, barriers to implementation, and emerging diagnostic technologies. The review found that colonoscopy offers the highest diagnostic yield and the singular advantage of immediate polypectomy, but its invasiveness, cost, and endoscopic capacity requirements substantially limit uptake, particularly in low-income populations. Non-invasive alternatives—principally FIT and multi-target stool DNA testing—demonstrate sufficient cancer detection performance to serve as effective primary screening tools, with considerably higher patient participation rates in population-based programs. Structural and socioeconomic barriers, including cost, limited healthcare access, and low health literacy, remain the primary determinants of screening inequity. Emerging technologies, such as blood-based circulating tumor DNA assays and wireless capsule endoscopy, show early clinical promise but require further prospective validation and cost reduction prior to large-scale adoption. This review concludes that no single modality simultaneously fulfills all clinical, economic, and equity requirements for an effective population-wide CRC screening programme. A risk-stratified, multi-modal approach—integrating non-invasive primary screening with targeted colonoscopy for confirmatory assessment and high-risk surveillance—represents the most clinically defensible and equitable strategy. Sustained investment in health education, subsidized access, and emerging diagnostic technologies is essential to reducing CRC-attributable mortality at a global scale.