Colorectal cancer screening strategies in Latin America remain relatively unexplored. However, a recent collaborative study by researchers from the Regenstrief Institute, Indiana University School of Medicine, University of Alabama at Birmingham, and University of North Carolina, Chapel Hill, has shed light on colorectal cancer screening programs in Latin America.
This groundbreaking research is among the first to identify and assess colorectal cancer screening initiatives in the region. The study revealed significant findings, including the absence of screening programs in low-middle-income countries like Honduras, El Salvador, Guatemala, and Bolivia.
Moreover, the researchers discovered that the prevalence of colorectal cancer in high-middle-income countries such as Brazil, Argentina, Uruguay, and Chile is comparable to that in high-income countries. Early detection through screening allows for either timely diagnosis with better prognosis or prevention through the removal of pre-cancerous polyps. This is crucial as colorectal cancer ranks as the second leading cause of cancer-related deaths worldwide, often without symptoms in its early stages.
Despite colorectal cancer predominantly affecting high-income countries globally, both incidence and mortality rates are on the rise in low- and high-middle-income countries, including most Latin American nations. While a comprehensive overview of colorectal cancer in Latin America is hindered by incomplete data collection from cancer registries, its incidence is increasing.
The study authors attribute this trend to limited resources, infrastructure, and public awareness in the region. They stress the urgent need for expanded screening programs and advocate for research focusing on prevention throughout Latin America.
The research team conducted a review and analysis of cancer screening studies in Latin America, encompassing nearly 124,000 participants and spanning publications in English, Spanish, and Portuguese. Their findings revealed successful implementation of colon cancer screening strategies, utilizing either noninvasive fecal immunochemical tests (FIT) or screening colonoscopies, in high-middle-income Latin American countries such as Brazil, Argentina, Mexico, Costa Rica, Uruguay, and Chile.
These countries exhibited high uptake rates (86 percent) of screening, with over 75 percent of patients undergoing colonoscopy following positive stool test results. According to study senior author Dr. Thomas Imperiale from the Regenstrief Institute, these findings suggest that structured population-level screening programs in Latin America, particularly in high-middle-income countries, could be as effective in reducing colorectal cancer burden as they are in other regions.
Dr. Eleazar Montalvan-Sanchez, the study’s first author and an internal medicine resident physician at IU School of Medicine, emphasized the significance of these findings for patients, physicians, and policymakers both in the U.S. and Latin America. He noted the importance of raising awareness about colorectal cancer screening, especially among Latin American immigrant populations in the U.S., who may be less familiar with such preventive measures.
“Most of the patients who I see here in Indianapolis are immigrants from Latin America who speak little English. When I try to discuss colorectal cancer screening with them it’s something new, something they have not been exposed to, unlike, for example, the availability of COVID vaccines.
“I recall a recent patient who immediately refused a colonoscopy but didn’t give me any reason. When, at his next appointment, we discussed his refusal, he shared that he had said no because he had never heard about it [colorectal cancer screening]before. It’s important for physicians in the U.S. to know about colon cancer screening in Latin America as we work to improve health outcomes for this population” said Dr. Eleazar Montalvan-Sanchez.
In conclusion, the study underscores the substantial burden of colorectal neoplasia in Latin America and the feasibility of organized screening programs. It calls for increased data collection on colorectal cancer burden and screening feasibility, particularly in low-middle-income countries in the region. With colorectal cancer incidence rising rapidly in Latin America, effective preventive measures, including cost-effective FIT-based screening programs, should become a greater research and public health priority.
Paper: “Colorectal Cancer Screening Programs in Latin America” is published in JAMA Network Open. This study was funded in part by the National Institutes of Health’s National Cancer Institute.
