A Q&A with Prof. Evelien Dekker

March marks Colorectal Cancer Awareness Month, the perfect time to highlight one of the most common and leading causes of cancer-related deaths worldwide. Colorectal cancer (CRC) accounts for approximately 10% of all cancer cases¹, and it is often diagnosed at an advanced stage when treatment options are limited².

The importance of screening and prevention

CRC screening plays a crucial role in the early detection and prevention of colorectal cancer, offering the best opportunity to remove precancerous lesions before they can develop into cancer³. In our interview with Prof. Evelien Dekker, Gastrointestinal Oncology specialist at UMC Amsterdam and Global Chair of the Colorectal Cancer Screening Committee of the World Endoscopy Organization, she shared her valuable insights on colorectal cancer screening and its evolution.

Talking with the expert: Insights from Prof. Dekker

Q1: How do you see the global landscape of colorectal cancer screening evolving, particularly in light of advances in digital health and endoscopic techniques?

Prof. Dekker:
The incidence and burden of CRC (Colorectal cancer) are still rising, especially in countries where population screening programs have not been implemented. I am a strong supporter of organized screening using non-invasive tests, such as stool or blood tests, and performing colonoscopy only in those with a high risk of having cancer or advanced premalignant lesions, at the highest quality.

Q2: Given your expertise in both average-risk and high‑risk populations, how do you balance the challenges of ensuring early detection in diverse groups, and what role do you believe genetic testing will play in the future of personalized colorectal cancer screening?

Prof. Dekker:
CRC screening aims for the early detection and prevention of CRC in individuals at average risk. Those at increased risk, such as due to genetic or familial factors, should be identified and have adjusted surveillance programs. Identification of such risk is not always straightforward. Individuals may have one or more first-degree family members with CRC, sometimes at an early age and/or with a high number of polyps (polyposis), but not always. Genetic screening may indeed identify those with clear genetic risk (which is not the case for everyone), but it also has several disadvantages, and its cost-effectiveness should first be studied. Once a colonoscopy is performed, it should be done at the highest achievable quality, i.e., detecting all relevant lesions with an acceptable burden for the patient.

Q3: With March being Colorectal Cancer Awareness Month, how do you think public awareness campaigns can be more effective in promoting early screening, especially in populations that are less likely to participate in regular screenings, such as those with a lower perceived risk?

Prof. Dekker:
In my opinion, public awareness campaigns are crucial for raising awareness about this issue! People should be informed about the potential symptoms of CRC, the significance of having a 'positive family history' and being at increased risk for CRC, and, especially, the benefits of screening programs. Participation in screening is suboptimal, and in several European countries, it is even declining. We are currently working on understanding how to optimally inform the general population, including specific subgroups. Social media and other methods may also prove to be useful.

PENTAX Medical: Industry perspective

At PENTAX Medical, we are committed to empowering healthcare professionals with advanced endoscopic solutions that enable accurate and timely diagnoses. By supporting high-quality screenings and innovative detection methods, we aim to improve patient outcomes and save lives. During Colorectal Cancer Awareness Month, we encourage individuals to take care of their health. Talk to your healthcare provider about screening options – early detection can make the difference!

¹ Bray et al., 2023, CA: A Cancer Journal for Clinicians
² Arnold et al., 2022, Gut
³ Levin et al., 2018, Gastroenterology