Strengthening colonoscopy screening in primary care - A preventive imperative before the coming surge

Sep 23, 2026

India faces a critical inflection point in cancer control, yet colorectal cancer (CRC)—a largely preventable malignancy—remains absent from national preventive health priorities despite rising incidence. With roughly 70,000 new cases and 41,000 deaths annually and projections of doubling by 2050, complacency is no longer viable. Evidence shows colonoscopy screening can reduce mortality by over 30%, making systematic CRC screening integration into primary care an urgent preventive strategy before demographic and lifestyle changes overwhelm capacity.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

AbstrAct

Introduction

The Silent Emergence of a Preventable Cancer

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Editorial
| | --- | | | | Strengthening colonoscopy screening in primary care: A preventive imperative before the coming surge
Manas Pustake1 , Raman Kumar2,3
¹Department of Internal Medicine, Texas Tech University Health El Paso, El Paso, Texas, USA, ²Chief Editor, Journal of Family Medicine and Primary Care, Uttar Pradesh, India, 3President, Academy of Family Physicians of India, Ghaziabad,
Uttar Pradesh, India | | AbstrAct
India stands at a critical juncture in its cancer control efforts. While cervical, breast, and oral cancers receive substantial screening attention, colorectal cancer (CRC), a largely preventable disease, remains conspicuously absent from the national preventive health agenda. With approximately 70,000 new cases and 41,000 deaths annually, and projections indicating a doubling of this burden by 2050, the time for complacency has passed. Colonoscopy screening, proven globally to reduce mortality by over 30%, represents an underutilized intervention that could spare hundreds of thousands of lives in India. This editorial argues for the urgent integration of systematic CRC screening into India’s primary healthcare framework before demographic and lifestyle shifts render the problem unmanageable.
Keywords: Cancer screening policy, colonoscopy screening, colorectal cancer prevention, GLOBOCAN data, primary care | Introduction India’s cancer landscape is changing in quiet but consequential ways. As the nation moves through its demographic, and epidemiologic transition, the balance of disease is tilting steadily toward noncommunicable causes. Cardiovascular disorders, diabetes, and cancers now account for most of the adult morbidity and mortality, a shift accelerated by urbanization, dietary change, and population aging. Within this expanding spectrum, Colorectal cancer (CRC) has remained curiously underrecognized: significant enough to trouble oncologists, yet absent from the country’s preventive health agenda. The reasons for this invisibility are both statistical and perceptual. India’s current age‑standardized CRC incidence rates, 2.4 per Address for correspondence: Dr. Manas Pustake, Department of Internal Medicine, Texas Tech University Health El Paso, Texas, USA. Received: 08‑01‑2026 Accepted: 09‑01‑2026 E‑[mail: Manas.Pustake@ttuhsc.edu](mail: Manas.Pustake@ttuhsc.edu) Revised: 09‑01‑2026 Published: 07‑02‑2026 | Access this article online | | | --- | --- | | Quick Response Code:
| Website:
[http://journals.lww.com/JFMPC](http://journals.lww.com/JFMPC) | | | DOI:
10.4103/jfmpc.jfmpc_43_26 | 100,000 for colon and 2.2 per 100,000 for rectum, appear modest compared with Western figures exceeding 20 per 100,000.[1] This apparent reassurance has, paradoxically, delayed policy attention. But as life expectancy increases and dietary patterns converge with those of industrialized nations, these low rates are giving way to rapid growth. GLOBOCAN 2022 data already estimate nearly 65,000 new colorectal cancers annually, and projections indicate that the burden will double by 2050, driven almost entirely by demographic expansion rather than changing individual risk. [1] What makes this trajectory especially concerning is that CRCis one of the few major cancers that can be prevented. The adenoma–carcinoma sequence unfolds slowly over a decade or more, offering a long window for intervention. Effective screening, through colonoscopy or stool‑based testing, can interrupt this process entirely. Yet, unlike breast or cervical cancer, CRC has no place in India’s national screening framework. The resultis a widening “colonoscopy gap:” a growing population at risk, and an endoscopic infrastructure insufficient to meet even present diagnostic demand. This is an open access article distributed under the terms of the Creative Commons Attribution‑NonCommercial‑NoDerivatives 4.0 License (CC BY‑NC‑ND), where it is permissible to download and share the work provided it

FAQs

Why is colorectal cancer (CRC) described as underrecognized in India’s preventive health agenda?

CRC is considered sufficiently significant to concern oncologists but still largely invisible within primary-care priorities, leaving screening policy gaps.

What role does colonoscopy screening play in reducing CRC mortality?

Colonoscopy screening is presented as an underutilized intervention proven globally to reduce mortality by more than 30%.

What factors are expected to drive an increase in CRC burden in India by 2050?

The document links the projected doubling of CRC burden primarily to demographic expansion and future convergence of lifestyle patterns with industrialized nations.

Sep 23, 2026

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