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World J Gastroenterol. Nov 21, 2026; 32(43): 122311
Published online Nov 21, 2026. doi: 10.3748/wjg.122311
Published online Nov 21, 2026. doi: 10.3748/wjg.122311
Modelling the impact of colorectal cancer screening strategies: A systematic review and meta-analysis
Yi-Ke Yan, Yue-Lun Zhang, Bin Lu, Zhi-Liang He, Xin-Ran Cheng, Yu-Qing Chen, Hong-Da Chen, Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Yi-Ke Yan, Bin Lu, Zhi-Liang He, Min Dai, Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
Bin Lu, Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 101118, China
Kai Song, Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
Jing-Jing Han, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Co-first authors: Yi-Ke Yan and Yue-Lun Zhang.
Co-corresponding authors: Hong-Da Chen and Min Dai.
Author contributions: Dai M and Chen HD contributed equally to this work as co-corresponding authors; they supervised the study, contributed to the interpretation of findings, critically revised the manuscript, and approved the final version. Yan YK, Zhang YL, Lu B and He ZL contributed equally to this work as co-first authors; they made substantial intellectual contributions to the conception and design of the study, data extraction, data analysis and interpretation, and manuscript preparation. Specifically, Yan YK, Lu B and He ZL conducted data extraction; Yan YK performed data analysis and drafted the initial manuscript; Zhang YL and Lu B provided methodological support and contributed to manuscript revision; Cheng XR, Song K, Chen YQ and Han JJ verified the data. All authors reviewed and approved the final version of the manuscript.
AI contribution statement: ASReview, an open-source machine learning tool, was used during title and abstract screening solely to prioritize records by predicted relevance; all eligibility decisions were made by the authors. During manuscript preparation, GPT-5 (OpenAI, San Francisco, CA, United States) was used solely for linguistic refinement, grammar correction, formatting assistance, and improvement of clarity and readability. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Supported by Capital’s Funds for Health Improvement and Research (CFH), No. 2026-2G-4026; PUMCH Talent Development and Support Program (Category B), No. UGG06641; National Key Research and Development Project of China, No. 2024YFA0918501; the National Natural Science Foundation of China, No. 82273726 and No. 82473705; Beijing Research Ward Excellence Program, No. BRWEP2024W034010101; the Fundamental Research Funds for the Central Universities, Peking Union Medical College, No. 3332025126; and the Science and Technology Planning Project of Tibet Autonomous Region, No. XZ202501JD0021.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Hong-Da Chen, Professor, Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China.
Received: April 16, 2026
Revised: May 13, 2026
Accepted: June 26, 2026
Published online: November 21, 2026
Processing time: 163 Days and 19.2 Hours
Revised: May 13, 2026
Accepted: June 26, 2026
Published online: November 21, 2026
Processing time: 163 Days and 19.2 Hours
Core Tip
Core Tip: This meta-analysis of modeling studies shows that colorectal cancer screening substantially reduces incidence and mortality, with 10-yearly colonoscopy being most effective under perfect adherence. Emerging and hybrid strategies appear promising but with uncertain cost-effectiveness. Outcomes are strongly influenced by adherence and modelling assumptions, highlighting the need to balance effectiveness, real-world implementation, and economic considerations in screening policy decisions.