Current Status of Colorectal Cancer and Its Public Health Burden in Thailand
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Colorectal cancer (CRC) accounts for approximately 10.3% of new cancer cases in Thailand and is currently the 3rd most prevalentcancer found among the Thai population. Starting in 2017, the Thai government announced the national CRC screening program asa response to this important issue. Among the 70 million people currently residing in Thailand, 14 million require screening, whilethere are approximately a total of 1,000 endoscopists available to perform colonoscopy. Due to the limited resources and shortage ofendoscopists in Thailand, applying a population-based one-step colonoscopy program as a primary screening method is not feasible. To reduce colonoscopy workload, with the help of others, including village health volunteers, institution-based health personnel,reimbursement coders, pathologists, and patients due for CRC screening, a two-step approach of one-time fecal immunochemicaltest (FIT), which prioritizes and filters out subjects for colonoscopy, is chosen. Moreover, additional adjustments to the optimal FITcutoff value and the modified Asia-Pacific Colorectal Screening risk score, including body weight, were proposed to stratify thepriority of colonoscopy schedule. This article aims to give an overview of the past and current policy developmental strategies andthe current status of the Thailand CRC screening program.
Abstract
Colorectal cancer (CRC) accounts for approximately 10.3% of new cancer cases in Thailand and is currently the 3rd most prevalentcancer found among the Thai population. Starting in 2017, the Thai government announced the national CRC screening program asa response to this important issue. Among the 70 million people currently residing in Thailand, 14 million require screening, whilethere are approximately a total of 1,000 endoscopists available to perform colonoscopy. Due to the limited resources and shortage ofendoscopists in Thailand, applying a population-based one-step colonoscopy program as a primary screening method is not feasible. To reduce colonoscopy workload, with the help of others, including village health volunteers, institution-based health personnel,reimbursement coders, pathologists, and patients due for CRC screening, a two-step approach of one-time fecal immunochemicaltest (FIT), which prioritizes and filters out subjects for colonoscopy, is chosen. Moreover, additional adjustments to the optimal FITcutoff value and the modified Asia-Pacific Colorectal Screening risk score, including body weight, were proposed to stratify thepriority of colonoscopy schedule. This article aims to give an overview of the past and current policy developmental strategies andthe current status of the Thailand CRC screening program.
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