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

Abstract PDF Supplementary Material PubReader ePub

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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Changes in Uptake, Participant Disparities, and Screening Outcomes of the Korean National Lung Cancer Screening Program: A Five-Year Experience: Chang Kyun Choi, Na-Young Lee, Mina Suh, Kui Son Choi, Yeol Kim; Received January 15, 2025 Accepted November 6, 2025 Published online November 10, 2025; DOI: https://doi.org/10.4143/crt.2025.067 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Purpose
Low-dose computed tomography (LDCT) is effective in reducing lung cancer mortality among high-risk smokers. The Korean National Lung Cancer Screening Program (KNLCS), the world’s first nationwide lung cancer screening initiative using LDCT, was launched in 2019. This study aimed to evaluate the KNLCS uptake rates in relation to participants’ economic status and changes in positive screening rates across screening rounds.
Materials and Methods
Data from the National Health Insurance Service (NHIS) and the National Cancer Screening Information System for 2019-2023 were analyzed. Eligible participants in the KNLCS were current smokers aged 54-74 years with a smoking history of at least 30 pack-years. The KNLCS provides counseling by physicians on screening results and smoking cessation. Screening uptake rates, counseling rates, and Lung CT Screening Reporting and Data System (Lung-RADS) distributions were assessed.
Results
Screening uptake rates increased from 24.7% in 2019 to 51.2% in 2023 (p < 0.001). Economic disparities were observed, with higher-income groups showing consistently higher uptake rates than lower-income groups. Screening positive rates have decreased from 9.1% in 2019 to 7.0% in 2023 due to the increasing proportion of subsequent screening participants. The interinstitutional variance in Lung-RADS category 4 decreased significantly over the years (p < 0.001).
Conclusion
The KNLCS rapidly increased screening uptake rates by systematically inviting eligible participants. Positive screening rates decreased primarily due to a reduction in Lung-RADS category 3 findings in subsequent rounds.

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Special Article

Trends in Cancer-Screening Rates in Korea: Findings from the National Cancer Screening Survey, 2004-2023: EunKyo Kang, Kui Son Choi, Jae Kwan Jun, Yeol Kim, Hyeon Ji Lee, Chang Kyun Choi, Tae Hee Kim, Sun Hwa Lee, Mina Suh; Cancer Res Treat. 2025;57(1):28-38. Published online August 2, 2024; DOI: https://doi.org/10.4143/crt.2024.325

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to report the overall national trends in the rates of cancer screening based on recommendations and provide insights into the changing trends of these rates across different demographics.
Materials and Methods
This study used data from the Korean National Cancer Screening Survey (KNCSS), which surveys nationwide cancer-screening rates and includes 4,500 individuals meeting the Korean National Cancer Screening Program (NCSP) protocol age criteria. Cancer-screening rates were assessed using structured questionnaires; yearly trends were analyzed for both lifetime cancer-screening rates and rates of screening based on recommendations, and subgroup analyses were performed based on age and sex.
Results
The rates of cancer screening based on recommendations showed significant increments: the stomach cancer-screening rate increased from 39.2% in 2004 to 77.5% in 2023 (3.50% per year), the liver cancer-screening rate increased from 20.0% to 48.8% (4.30% per year), and the colorectal cancer, increased from 19.9% to 70.7% (5.15% per year). The breast cancer-screening rate increased from 33.2% to 72.7% (2.88% per year), and the cervical cancer, increased from 58.3% to 70.2% (1.08% per year). Despite some differences, particularly in relation to sociodemographic factors, screening rates increased significantly for all cancer types.
Conclusion
Cancer-screening rates in Korea increased consistently from 2004 to 2023, demonstrating the effectiveness of the national cancer-screening program. However, the increments in breast, cervical and lung cancer-screening rates were relatively lower, indicating the need for additional efforts and strategies.

Citations

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Optimal interval of screening endoscopy for reducing gastric cancer mortality: a nationwide cohort study
Soo-Yoon Sung, Hyun Ho Choi, Seung Ho Sin, Hyung-Keun Kim, Sang Woo Kim, Sung Soo Kim
Gastrointestinal Endoscopy.2026; 103(4): 725. CrossRef
Practice of Cytopathology in Korea: A 40‐Year Evolution Through Standardization, Digital Transformation, and Global Partnership
Yosep Chong, Ran Hong, Hyeong Ju Kwon, Haeryoung Kim, Lucia Kim, Soon Jae Kim, Yoon Jung Choi
Diagnostic Cytopathology.2026; 54(2): 146. CrossRef
Information Landscape on Cervical Cancer: An Analysis of News and Online Platform Data in the Republic of Korea
Hye-Sun Lee, Gyeong-U Hong, Wonjeong Jeong, Kyounghee Oh, Jae Kwan Jun
Health Communication.2026; 41(10): 1708. CrossRef
Persistent income-related inequalities in cancer screening utilisation in South Korea: Evidence from repeated cross-sectional data, 2013–2023
Soyun An, Sunghyun Yi, Jihyung Hong
Public Health.2026; 252: 106157. CrossRef
Racial/ethnic and geographic differences in second primary cancers in stomach cancer survivors: a comparative study of U.S. and South Korea
Yuntong Wang, Dong-Woo Choi, Sangwon Lee, Jialin Mao, Art Sedrakyan, Xiang Shu, Kui Son Choi, Heejung Chae, Eunji Choi
Gastric Cancer.2026; 29(3): 506. CrossRef
The impact of an organized screening program on gastric cancer incidence: a quasi-experimental study
Dianqin Sun, Duco T Mülder, Kyu-Won Jung, Jin Young Park, Mina Suh, Yige Li, Daan Nieboer, Chisato Hamashima, Weiran Han, Manon C W Spaander, Uri Ladabaum, Robert J Huang, James F O’Mahony, Iris Lansdorp-Vogelaar
International Journal of Epidemiology.2026;[Epub] CrossRef
International trends in cancer mortality revisited: Japan’s site-specific progress and remaining challenges until 2024
Kota Katanoda, Hirokazu Tanaka, Yuri Ito
Japanese Journal of Clinical Oncology.2026; 56(6): 787. CrossRef
Temporal trends and future projections of colorectal cancer burden in East Asia: an analysis of GBD 2021 data for China, South Korea, and Japan (1990–2050)
Yuren Zhang, Yongchao Zhang, Keqiang Lu, Huirong Zhu
International Journal of Surgery.2026; 112(3): 8164. CrossRef
Source-specific short-term-ozone exposure and specific cancer mortality risk: A multi-country study in 11,215 communities
Pei Yu, Rongbin Xu, Wenzhong Huang, Yanming Liu, Zhengyu Yang, Michael J. Abramson, Eric Lavigne, Simon Hales, Lidia Morawska, Paulo H.N. Saldiva, Fay H. Johnston, Luke Knibbs, Geoffrey Morgan, Guy B. Marks, Jane Heyworth, Ho Kim, Kraichat Tantrakarnapa,
Journal of Hazardous Materials.2026; 508: 141822. CrossRef
Population Colorectal Cancer Screening in Asia: Insights From Established Programs
Wen‐Feng Hsu, Masau Sekiguchi, Jeongkuk Seo, Hyun‐Soo Kim, Takahisa Matsuda, Han‐Mo Chiu
Journal of Gastroenterology and Hepatology.2026; 41(5): 1415. CrossRef
Impact of South Korea’s national gastrointestinal cancer screening programme on incidence and mortality: a population-based difference-in-differences study
Jaewoo Cha, Minku Kang
BMJ Open.2026; 16(4): e112558. CrossRef
Detección precoz del cáncer colorrectal
Alejandro J. Zárate, Suraj Samtani, Roberto Salas, Camila Leiva
Revista Médica Clínica Las Condes.2026; 37(2): 147. CrossRef
Global inequalities in tracheal, bronchus, and lung cancer care quality from 1990 to 2021
Yafen Wang, Enhui Zhou, Zhengyu Shi, Weijun Huang, Tianjiao Zhou, Chen Xu, Jinxiu Yao, Jing Wang, Siqiong Jiang, Fang Fang, Wen Lu, Hongliang Yi
iScience.2026; 29(7): 116604. CrossRef
Understanding barriers and facilitators to cervical cancer prevention among young Korean Women: A focus group interview study
Hyun Jin Kim, Hyeon Ji Lee, Hye Young Shin, Hye-Sun Lee, Jae Kwan Jun, Kui Son Choi, Mina Suh, Fatemeh Zarei
PLOS One.2026; 21(7): e0353242. CrossRef
Decline in Years of Life Lost Due to Diabetes in Korea, 2008–2019: A Cause-Specific Decomposition Analysis
Da Hea Seo, Kyoung Hwa Ha, Dae Jung Kim
Endocrinology and Metabolism.2026; 41(4): 558. CrossRef
Emerging cancer incidence trends in younger generations: age-specific trends and birth cohort effects from 25 years of Korean Cancer Registry data
Bohyun Park, Hye Ah Lee, Bomi Park, Hyesook Park
Cancer Epidemiology.2026; 104: 103209. CrossRef
Association Between Suicidal Ideation and Cancer Screening Uptake: Results from Middle-Aged and Older Adults in Korea
Seong-Uk Baek, Jin-Ha Yoon
Cancers.2025; 17(6): 956. CrossRef
From pilot to policy: what Korea’s LDCT program teaches us about National Lung Cancer Screening
Lisa Jungblut
European Radiology.2025; 35(12): 8162. CrossRef
Current Status of the National Cancer Screening Program in Korea: History, Achievements, and Future Directions
Kyeongmin Lee, Mina Suh, Kui Son Choi
Journal of Preventive Medicine and Public Health.2025; 58(4): 337. CrossRef
Inequalities in breast cancer incidence and mortality in women with and without disabilities in South Korea: A population-based cohort study
Hee-Yeon Kang, Eunjung Park, Thi Tra Bui, Byungmi Kim, Jin-Kyoung Oh
Preventive Medicine Reports.2025; 59: 103242. CrossRef
Presentation of Benefits and Harms in Cancer Screening Guidelines for Koreans: A Systematic Review
Mi Ah Han, Hunju Lee, Kwangmin Kim, Seong Jung Kim, Eu Chang Hwang, Jae Hung Jung
Cancer Research and Treatment.2025; 57(4): 923. CrossRef
Association of Elevated Serum Triglycerides with Colorectal Cancer Risk: Findings from a Large-scale Prospective Cohort of Korean Adults
Sukhong Min, Hyobin Lee, Sinyoung Cho, Seung-Yong Jeong, Aesun Shin, Daehee Kang
Cancer Prevention Research.2025; 18(11): 681. CrossRef

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22 Web of Science
22 Crossref

Original Article

Gastrointestinal Cancer

Association between ALDH2 and ADH1B Polymorphisms and the Risk for Colorectal Cancer in Koreans: Chang Kyun Choi, Min-Ho Shin, Sang-Hee Cho, Hye-Yeon Kim, Wei Zheng, Jirong Long, Sun-Seog Kweon; Cancer Res Treat. 2021;53(3):754-762. Published online December 24, 2020; DOI: https://doi.org/10.4143/crt.2020.478

Abstract PDF PubReader ePub

Purpose
Excessive alcohol consumption has been linked to an increased risk of colorectal cancer (CRC). We evaluated the association between alcohol-related genetic variants and CRC risk.
Materials and Methods
The study cohort consisted of 5,435 CRC cases and 3,553 population-based cancer-free controls. Genotype data were generated from germline DNA using the Infinium OncoArray-500K BeadChip in 2,535 cases and 2,287 controls and the Infinium Multi-Ethnic Global BeadChip in 2,900 cases and 1,266 controls. The associations between aldehyde dehydrogenase 2 (ALDH2) rs671 and alcohol dehydrogenase 1B (ADH1B) rs1229984 polymorphisms and CRC risk were assessed using multivariate logistic regression analyses.
Results
Compared with the major homozygous ALDH2 genotype (GG), heterozygous or minor homozygous ALDH2 genotype (GA or AA, related to a low alcohol consumption) was significantly associated with a reduced risk for CRC in men (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.68 to 0.90), but not in women (OR, 0.70; 95% CI, 0.47 to 1.05). A stronger association was found among regular drinkers (OR, 0.58; 95% CI, 0.47 to 0.71 in men and OR, 0.33; 95% CI, 0.18 to 0.58 in women). No association of CRC risk with ADH1B rs1229984 genotype was found. The association between alcohol-related combined genotypes and risk of CRC was significant (p for linear=0.001). The combined genotype with the highest genetically predicted alcohol consumption (ALDH2 rs671 GG and ADH1B rs1229984 AG/GG) was associated with a high risk for CRC (OR, 1.35; 95% CI, 1.11 to 1.63).
Conclusion
Our study provides strong evidence for a possible causal association between alcohol consumption and CRC risk.

Citations

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European Journal of Medical Research.2026;[Epub] CrossRef
ADH1B regulates tumor stemness by activating the cAMP/PKA/CREB1 signaling axis to inhibit recurrence and metastasis of lung adenocarcinoma
Hairong Shi, Youtao Xu, Guoxin Song, Tianzhu Qiu
Biochemical and Biophysical Research Communications.2025; 760: 151681. CrossRef
Alcohol-Metabolizing Enzymes, Liver Diseases and Cancer
Tao Liu, FeiYu Zhang, Yue Feng, PanShiLi Han, YanHang Gao
Seminars in Liver Disease.2025; 45(01): 099. CrossRef
Genetic Polymorphisms of ALDH2 and ADH1B in Alcohol-Induced Liver Injury: Molecular Mechanisms of Inflammation and Disease Progression in East Asian Populations
Tomoko Tadokoro, Kyoko Oura, Mai Nakahara, Koji Fujita, Joji Tani, Asahiro Morishita, Hideki Kobara
International Journal of Molecular Sciences.2025; 26(17): 8328. CrossRef
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Xueyuan Zhao, Yan Jia, Weijia Wen, Caixia Shao, Qiaojian Zou, Linna Chen, Hongye Jiang, Guofen Yang, Wei Wang, Chunyu Zhang, Shuzhong Yao
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Xiaoxia Tong, Chenghui Li, Li Ma, Di Wu, Yonglei Liu, Liqin Zhao, Mengyun Wang
Molecular Carcinogenesis.2024; 63(9): 1669. CrossRef
Impacts of ADH1B rs1229984 and ALDH2 rs671 polymorphisms on risks of alcohol‐related disorder and cancer
Ting‐Gang Chang, Ting‐Ting Yen, Chia‐Yi Wei, Tzu‐Hung Hsiao, I‐Chieh Chen
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Genetically determined alcohol consumption and cancer risk in Korea
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Dysregulated Expression of Three Genes in Colorectal Cancer Stratifies Patients into Three Risk Groups
Alba Rodriguez, Luís Antonio Corchete, José Antonio Alcazar, Juan Carlos Montero, Marta Rodriguez, Luis Miguel Chinchilla-Tábora, Rosario Vidal Tocino, Carlos Moyano, Saray Muñoz-Bravo, José María Sayagués, Mar Abad
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