Colorectal Cancer Screening in Saudi Arabia - Current Challenges and Future Directions

Q: Why is colorectal cancer screening in Saudi Arabia still insufficient despite national recommendations?

Screening uptake remains below 10% and colonoscopy in older adults is under 1% due to public knowledge gaps, cultural taboos, and healthcare system constraints that limit guideline implementation.

Q: What epidemiological features make early detection urgent in Saudi Arabia?

Late-stage detection is reported at roughly 29%, and evidence also indicates a substantial burden of regional or distant metastases, alongside an alarming rise in early-onset colorectal cancer in people under 50.

Q: What future measures does the review propose to improve screening outcomes?

A nationwide initiative is recommended, including a national registry, targeted public education to overcome cultural barriers, mobile screening units for rural regions, and AI-assisted diagnostics to strengthen existing survival rates.

Sep 22, 2026

Uploaded by Eliana

Colorectal cancer has become a major public health concern in Saudi Arabia, ranking as the most prevalent cancer among men and the third among women. Even with national recommendations to screen ages 45–75, screening uptake remains under 10%, with fewer than 1% of older adults receiving colonoscopy. Regional differences and late-stage detection—about 29%—along with rising early-onset disease motivate a review of epidemiological, social, and health-system barriers. Proposed solutions include a nationwide screening initiative, national registry, culturally tailored education, mobile screening units, and AI-assisted diagnostics.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Introduction

CRC screening recommendations and uptake

Barriers and implementation challenges

Regional incidence patterns and early-onset concern

Proposed national strategy and future directions

SAUDI MEDICAL JOURNAL 2026;47:10–20 Scan the QR to view the full-text article on the journal website REVIEW ARTICLE Colorectal Cancer Screening in Saudi Arabia: Current Challenges and Future Directions Abdulrahman A. Aljabri, MSC, PhD, Abdulrahman G. Alharbi, Pharm.D, PhD Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, AL Medina Al Munawarah, Kingdom of Saudi Arabia Colorectal cancer has become a major public health concern in Saudi Arabia. It is the most prevalent cancer among men and the third most prevalent among women. Although screening for people aged 45-75 is recommended by national recommendations, screening uptake is still below 10%, and less than 1% of older persons have a colonoscopy. With regional di􀀈erences that vary from age-standardized rates of 3.2 per 100,000 in Jouf to 21.8 per 100,000 in Riyadh among men, approximately 29% of cases are detected at late stages. Therefore, we assessed the epidemiological, social, and health-related systemic structures preventing e􀀈ective colorectal cancer screening in the region. Important barriers to colorectal cancer screening include a lack of public knowledge, cultural taboos, healthcare system constraints, and gaps in physician knowledge. Although some initiatives, such as fecal immunochemical testing, appear promising, screening rates remain exceptionally low. Furthermore, the alarming increase in early onset colorectal cancer in individuals aged <50 years underscores the need to screen high-risk individuals at younger ages. This review highlights the pressing necessity for a nationwide colorectal cancer screening initiative, which should encompass the creation of a national registry, focused public education campaigns to overcome cultural obstacles, mobile screening units for rural regions, and the incorporation of arti􀀉cial intelligence (AI)-assisted diagnostics to enhance the existing 5-year survival rates of 44–52% . Keywords: Colorectal cancer, Screening, Saudi Arabia, Barriers, Early detection, Public health, Health policy Saudi MedJ 2026; Vol. 47(1): 10–20 doi: 10.15537/smj.2026.47.1.20250597 Received 14 July 2025; accepted 16 September 2025 . Address correspondence and reprint request to: Abdulrahman A. Aljabri, MSC, PhD, Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, AL Medina Al Munawarah, Kingdom of Saudi Arabia E-mail: aa[jabri@taibahu.edu.sa](jabri@taibahu.edu.sa) Introduction. Colorectal cancer (CRC) is a major public health concern in Saudi Arabia [1] . The most current data from the Saudi Health Council Cancer Registry (2022) shows that colorectal cancer is the third most prevalent cancer among Saudi women and the most common cancer among Saudi men. In 2022, there were 2,535 incidents of CRC, representing 13.2% of all newly diagnosed malignancies among Saudi citizens, including 1,470 men (58%) and 1,065 women (42%), with a men-to-women ratio of 138:100 . The age-standardized incidence rates were 26.2 per 100,000 for men and 17.8 per 100,000 for women, with a median age at diagnosis of 60 years for men and 59 years for women. This signi􀀉es a signi􀀉cant rise from previous registry data indicating 1,908 cases (12.2%) in 2018, illustrating the escalating incidence of colorectal cancer in the Kingdom [2, 3] . Analysis of 17,541 colorectal cancer patients from the Saudi Cancer Registry (1997–2017) indicates that 29% are detected at an advanced stage, however other publications suggest that up to 50% present with regional or distant metastases [3] . Despite the introduction of screening recommendations in 2015, late-stage diagnosis rates continue to be extremely high, suggesting a little e􀀈ect of existing screening initiatives on early detection result [4] . This pattern profoundly a􀀈ects treatment outcomes and survival rates, as early diagnosis is essential for appropriate management and enhanced prognosis. Data from oncology centers in the Eastern Mediterranean Regio

FAQs

Why is colorectal cancer screening in Saudi Arabia still insufficient despite national recommendations?

Screening uptake remains below 10% and colonoscopy in older adults is under 1% due to public knowledge gaps, cultural taboos, and healthcare system constraints that limit guideline implementation.

What epidemiological features make early detection urgent in Saudi Arabia?

Late-stage detection is reported at roughly 29%, and evidence also indicates a substantial burden of regional or distant metastases, alongside an alarming rise in early-onset colorectal cancer in people under 50.

What future measures does the review propose to improve screening outcomes?

A nationwide initiative is recommended, including a national registry, targeted public education to overcome cultural barriers, mobile screening units for rural regions, and AI-assisted diagnostics to strengthen existing survival rates.

Sep 22, 2026

Uploaded by Eliana