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Original Article
- Korean Colorectal Cancer Screening Guidelines for Asymptomatic, average-Risk Adults: The 2025 Revision
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EunKyo Kang1
, Jae Myung Cha2
, Seo Young Kang3, Kiheon Lee4, Su Young Kim5, Younghoon Kim6, An Na Seo7, Hyo-Jin Kang8, Jong Keon Jang9, Kwang-Pil Ko10, Aesun Shin11, Dae Kyung Sohn12, Youngki Hong13, Eun-Jung Cho14, Minje Han15, Soo Young Kim16, Hyeon Ji Lee1, Chang Kyun Choi1, Mina Suh1
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DOI: https://doi.org/10.4143/crt.2026.014 [Accepted]
Published online: March 13, 2026
1National Cancer Control Institute, National Cancer Center, Goyang, Korea
2Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University College of Medicine, Seoul, Korea
3Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
4Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
5Department of Gastroenterology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
6Department of Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
7Department of Pathology, Kyungpook National University School of Medicine, Daegu, Korea
8Department of Radiology, Seoul National University Hospital, Seoul, Korea
9Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
10Clinical Preventive Medicine Center, Seoul National University Bundang Hospital, Seongnam, Korea
11Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
12Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
13Departments of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
14Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
15Department of Laboratory Medicine Kangdong Sacred Heart Hospital, Seoul, Korea
16Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
It was agreed that this article, despite having the same content, would be published in two journals (the JKMA and the CRT) in two different languages after undergoing the review process by each journal. The Korean version is to be published in the JKMA in March 2026, and the English version in the CRT in July 2026.
2Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University College of Medicine, Seoul, Korea
3Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
4Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
5Department of Gastroenterology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
6Department of Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
7Department of Pathology, Kyungpook National University School of Medicine, Daegu, Korea
8Department of Radiology, Seoul National University Hospital, Seoul, Korea
9Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
10Clinical Preventive Medicine Center, Seoul National University Bundang Hospital, Seongnam, Korea
11Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
12Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
13Departments of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
14Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
15Department of Laboratory Medicine Kangdong Sacred Heart Hospital, Seoul, Korea
16Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
It was agreed that this article, despite having the same content, would be published in two journals (the JKMA and the CRT) in two different languages after undergoing the review process by each journal. The Korean version is to be published in the JKMA in March 2026, and the English version in the CRT in July 2026.
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Corresponding author:
Mina Suh
Tel: 82-31-920-2911
Email: omnibus@ncc.re.kr
- EunKyo Kang and Jae Myung Cha contributed equally to this work.
Received: 5 January 2026 • Accepted: 27 February 2026
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Abstract
Purpose
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 (KQs) 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 moderate-certainty evidence for colonoscopy. Evidence for CT 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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