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Risk-Stratified Colorectal Cancer Screening and Surveillance

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: 30 September 2026 | Viewed by 360

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Guest Editor
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Adelaide 5042, Australia
Interests: epidemiology; colorectal cancer; risk prediction models; nutrition
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Special Issue Information

Dear Colleagues,

Colorectal cancer (CRC) screening and surveillance are evolving from uniform, interval-based strategies toward more personalized, risk-stratified approaches. As evidence continues to accumulate from longitudinal cohorts and surveillance programs, there is increasing recognition that individual risk varies substantially according to prior colorectal neoplasia, serrated lesions, test results and other clinical and behavioral factors. More precise stratification of risk may improve early detection of advanced neoplasia while also helping to optimize colonoscopy resources and reduce unnecessary procedures. Recent work in this area has highlighted the importance of integrating colonoscopic findings with adjunctive tools such as fecal immunochemical testing (FIT), as well as lifestyle and epidemiologic risk factors, to guide tailored surveillance pathways.

This Special Issue welcomes original research articles and reviews addressing advances in individualized CRC prevention and early detection. Topics of interest include risk prediction after adenomatous and serrated lesions, interval FIT in surveillance populations, surveillance colonoscopy strategies as well as epidemiologic and behavioral determinants of CRC risk.

Dr. Molla Wassie
Guest Editor

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Keywords

  • colorectal cancer
  • risk stratification
  • colonoscopy
  • advanced colorectal neoplasia
  • precision prevention

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Published Papers (1 paper)

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24 pages, 540 KB  
Systematic Review
Multicomponent Lifestyle Interventions During Colorectal Cancer Surveillance: A Systematic Review
by Meseret Derbew Molla, Erin L. Symonds, Jean M. Winter, Norma B. Bulamu, Melkalem Mamuye Azanaw and Molla M. Wassie
Cancers 2026, 18(12), 1906; https://doi.org/10.3390/cancers18121906 - 11 Jun 2026
Viewed by 150
Abstract
Background: Modifiable lifestyle factors may contribute additively to colorectal cancer (CRC) risk in individuals who already have non-modifiable risk factors, such as prior colorectal neoplasia or significant family history of CRC. However, the impact of multicomponent lifestyle interventions (such as dietary modification, [...] Read more.
Background: Modifiable lifestyle factors may contribute additively to colorectal cancer (CRC) risk in individuals who already have non-modifiable risk factors, such as prior colorectal neoplasia or significant family history of CRC. However, the impact of multicomponent lifestyle interventions (such as dietary modification, physical activity, and counselling) on behavioural modification, risk of colorectal neoplasia, and quality of life (QoL) in this population has not yet been systematically reviewed. Aims: The primary aim was behavioural change (change in body weight, diet, physical activity, sedentary lifestyle, smoking, and alcohol consumption). The secondary aim was colorectal neoplasia outcomes, including the incidence of precancerous lesions and/or cancer and CRC mortality/survival, and QoL, including specific domains. Methods: This review was conducted following the Cochrane guidelines for Systematic Reviews of Interventions. Both randomised and non-randomised studies assessing the effect of multicomponent lifestyle interventions on behavioural modification, risk of colorectal neoplasia, mortality, and quality of life in people at above-average risk of CRC were included. Medline/Ovid, Cochrane Library, Web of Science, and Scopus were searched. Screening, data extraction, and risk of bias assessment were independently performed by two reviewers using the revised Cochrane Risk of Bias (RoB) tools. Results: Of the 4174 studies screened, 10 interventional studies were eligible for inclusion, which had outcomes for behavioural change or quality of life. No interventions assessed neoplasia risk or mortality outcomes. Multicomponent lifestyle interventions mainly targeting diet and physical activity, delivered via a telephone-based or health coaching approach, showed positive effects on healthy behaviours and quality of life compared with usual care, although some studies reported inconsistent results. Conclusions: There is emerging evidence that multicomponent lifestyle interventions may offer beneficial effects on practicing healthy behaviours and improving QoL for individuals at above-average risk for CRC and undergoing colonoscopy surveillance. Full article
(This article belongs to the Special Issue Risk-Stratified Colorectal Cancer Screening and Surveillance)
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