Colonoscopy, Barriers, and Challenges for Colorectal Cancer Screening in Developing Countries

Abstract

Colorectal cancer (CRC) is the third most common cancer worldwide. The incidence of CRC is rising in developing countries but decreasing in developed countries due to the widespread use of screening and surveillance colonoscopy. The implementation of screening and surveillance programs remains a challenge in developing countries, especially Indonesia. Increasing screening rates among underserved populations in Indonesia, the world’s fourth most populous country, will reduce the global burden of colorectal cancer. The need for an integrated screening program in its healthcare system will provide a successful screening program. The purpose of a screening colonoscopy is to reveal the asymptomatic population with a certain disease through the use of an effective investigation to detect and treat the disease before it advances. Screening improves the prognosis of patients and the mortality rate. Removal of neoplastic polyps such as adenomas, the precancerous lesions during colonoscopy, is the cornerstone of screening colonoscopy. The detection rate is a measure of screening colonoscopy performance quality. Technology has been used to improve detection, such as mechanical technology (Endocuff) and optical, such as magnification, endocytoscopy, virtual chromoendoscopy, and recently artificial intelligence. Indonesia is a nation that is significantly affected by CRC and will benefit from screening colonoscopy.