Systematic review and meta-analysis of colorectal cancer screening prevalence in survivors versus general population

INTRODUCTION: This study aimed to determine the prevalence of colorectal cancer screening among cancer survivors and compare the likelihood of colorectal cancer screening among cancer survivors with that of the cancer-free general population. METHODS: A systematic search of MEDLINE (Ovid), EMBASE, PubMed, and CINAHL databases from inception through September 16, 2024 was conducted. Studies reporting colorectal cancer screening among cancer survivors or in both cancer survivors and cancer-free controls were included. Random effects meta-analyses were conducted to pool estimates. Analyses were performed across primary cancer sites where at least 3 studies were identified. RESULTS: Of the 2,492 articles identified, 59 fulfilled the inclusion criteria. The overall pooled prevalence of colorectal cancer screening (up to date for screening or had been screened during a specific time period after noncolorectal cancer diagnosis) was 0.53 (95% CI=0.46, 0.61), with estimates ranging from 0.72 (prostate) to 0.51 (breast) across primary cancer sites. Cancer survivors were more likely to participate in colorectal cancer screening than cancer-free controls (OR=1.39, 95% CI=1.26, 1.52), but there was some evidence of publication bias (Egger's test p=0.092). Study design, method of colorectal cancer screening ascertainment (self-report versus medical records), and first primary cancer site were significant sources of heterogeneity. DISCUSSION: Cancer survivors were more likely to undergo colorectal cancer screening than cancer-free controls, but overall rates were well below generally recommended levels for population-based screening. Future studies should evaluate the predictors of nonadherence to colorectal cancer screening among cancer survivors to inform policymakers in targeting populations with lower screening rates.