Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

Korean Colorectal Cancer Screening Guidelines for Asymptomatic, Average-Risk Adults: The 2025 Revision: EunKyo Kang, Jae Myung Cha, Seo Young Kang, Kiheon Lee, Su Young Kim, Younghoon Kim, An Na Seo, Hyo-Jin Kang, Jong Keon Jang, Kwang-Pil Ko, Aesun Shin, Dae Kyung Sohn, Youngki Hong, Eun-Jung Cho, Minje Han, Soo Young Kim, Hyeon Ji Lee, Chang Kyun Choi, Mina Suh; Cancer Res Treat. 2026;58(3):872-883. Published online March 13, 2026; DOI: https://doi.org/10.4143/crt.2026.014

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Purpose
This study aimed to develop the 2025 update to the Korean colorectal cancer (CRC) screening guidelines by systematically assessing recent evidence, integrating domestic data, and addressing changes since the 2015 guideline revision, and accordingly, provide an evidence-based standard for clinicians and policymakers.
Materials and Methods
A multidisciplinary committee developed the guidelines using the Grading of Recommendations, Assessment, Development and Evaluation methodology. The process involved establishing three key questions focused on efficacy, accuracy, and optimal age and interval for screening. A systematic review of international guidelines and primary literature (327 studies included) was conducted. A utility-based analysis using the Markov model was also performed to determine optimal screening ages and intervals.
Results
The review identified high-certainty evidence for fecal immunochemical test (FIT) in reducing CRC mortality and moderatecertainty evidence for colonoscopy. Evidence for computed tomography colonography (CTC) and stool DNA testing showed very low certainty. Based on this synthesis and cost-utility analysis, the committee conditionally recommends screening for asymptomatic, average-risk adults aged 45-74 years using either colonoscopy every 10 years or FIT every 1-2 years. CTC and stool DNA testing were not recommended owing to insufficient evidence.
Conclusion
The 2025 Korean Guidelines for Colorectal Cancer Screening provide the latest evidence-based recommendations tailored to the domestic context. By conditionally adopting both colonoscopy and FIT for individuals aged 45-74 years, these guidelines aim to optimize public health outcomes and reduce the colorectal cancer burden in South Korea.

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Age-dependent effects of gastric cancer screening endoscopy on mortality: a nationwide cohort study
Seokho Myeong, Jaehun Jung, Ki-Hwan Bae, Ilsoo Kim, Donghoon Kang, Yu Kyung Cho, Hyeon Woo Yim, Jae Myung Park
Endoscopy.2026;[Epub] CrossRef

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Ligand-Independent Epidermal Growth Factor Receptor Overexpression Correlates with Poor Prognosis in Colorectal Cancer: Sumi Yun, Yoonjin Kwak, Soo Kyung Nam, An Na Seo, Heung-Kwon Oh, Duck-Woo Kim, Sung-Bum Kang, Hye Seung Lee; Cancer Res Treat. 2018;50(4):1351-1361. Published online January 17, 2018; DOI: https://doi.org/10.4143/crt.2017.487

Abstract PDF Supplementary Material PubReader ePub

Purpose
Molecular treatments targeting epidermal growth factor receptors (EGFRs) are important strategies for advanced colorectal cancer (CRC). However, clinicopathologic implications of EGFRs and EGFR ligand signaling have not been fully evaluated. We evaluated the expression of EGFR ligands and correlation with their receptors, clinicopathologic factors, and patients’ survival with CRC.
Materials and Methods
The expression of EGFR ligands, including heparin binding epidermal growth factor-like growth factor (HBEGF), transforming growth factor (TGF), betacellulin, and epidermal growth factor (EGF), were evaluated in 331 consecutive CRC samples using mRNA in situ hybridization (ISH). We also evaluated the expression status of EGFR, human epidermal growth factor receptor 2 (HER2), HER3, and HER4 using immunohistochemistry and/or silver ISH.
Results
Unlike low incidences of TGF (38.1%), betacellulin (7.9%), and EGF (2.1%), HBEGF expression was noted in 62.2% of CRC samples. However, the expression of each EGFR ligand did not reveal significant correlations with survival. The combined analyses of EGFR ligands and EGFR expression indicated that the ligands‒/EGFR+ group showed a significant association with the worst disease-free survival (DFS; p=0.018) and overall survival (OS; p=0.005). It was also an independent, unfavorable prognostic factor for DFS (p=0.026) and OS (p=0.007). Additionally, HER4 nuclear expression, regardless of ligand expression, was an independent, favorable prognostic factor for DFS (p=0.034) and OS (p=0.049), by multivariate analysis.
Conclusion
Ligand-independent EGFR overexpression was suggested to have a significant prognostic impact; thus, the expression status of EGFR ligands, in addition to EGFR, might be necessary for predicting patients' outcome in CRC.

Citations

Citations to this article as recorded by

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Kailun Xu, Shu Zheng, Baosheng Li, Yingkuan Shao, Xiaoyang Yin
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Combined Therapeutic Effects of ¹³¹I-Labeled and 5Fu-Loaded Multifunctional Nanoparticles in Colorectal Cancer

Pingping Wu, Huayun Zhu, Yan Zhuang, Xiaofeng Sun, Ning Gu
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A. A. Rosenkranz, T. A. Slastnikova
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Co-expression and prognostic significance of putative CSC markers CD44, CD133, wild-type EGFR and EGFRvIII in metastatic colorectal cancer
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