The global rise in incidence of colorectal cancer among young women and the role of health education, public health campaign and digital innovation to reach universal health coverage
Abstract
The third most common cancer diagnosed globally is colorectal cancer (CRC) which is a significant cause of cancer-related mortality. While the overall incidence of CRC is decreasing in the older populations due to successful screening programs and advancements in modern medicine, there is an alarming rise in early onset CRC (EOCRC), defined as CRC under the of age 50. This paradoxical epidemiological shift highlights a crucial gap in current public health strategies and underpins the fundamental commitment of Universal Health Coverage (UHC) under WHO Target 3.8: Achieve universal health coverage, including access to essential health services (particularly in terms of vaccinations, screenings, health education).
Background
Early detection and treatment can significantly improve survival rate and regular screening of the identified risk groups can reduce both the incidence and mortality of CRC through early detection and treatment such as surgical removal of precancerous polyp growths, chemotherapy, radiation, targeted therapy, or immunotherapy. Studies have shown EOCRC is seldom diagnosed in early disease stage in young women. This is due to reliance on standard age-based screening guidelines (starting at 45 or 50 in most counties), misdiagnosis, lack of awareness and importantly emerging lifestyle behaviors such as obesity, lack of exercise, smoking, dietary factors, and altered gut microbiome.2
Method
In this article I amalgamated the results of metanalyses regarding the current epidemiological and etiological trends of EOCRC in young women to address specific risk factors and proposed health education recommendations for integrating effective primary preventive and early screening detection services, suggest innovative approaches such as mobile health apps, telemedicine, AI-based tools, and finally policy and system-level interventions. 
Results
Increasing screening prevalence to 80% could reduce the incidence by 22% and CRC-related mortality by 33% by 2030. About 89% of adults diagnosed with CRC at stage I, can live for 5 years or more, compared to only 16% of those diagnosed at stage IV. Increasing screening prevalence to 70% among adults could reduce healthcare spending by $14 billion by 2050 because early disease is cheaper to treat.
Conclusions/Implications
There is great emphasize on preventive and promotive services by the World Health Organization’s Global Report on Universal Health Coverage (UHC). Specifically, indicator 3.8.1 which aims to achieve universal health coverage, including access to essential health services particularly in terms of preventive screenings and health education. However, there is an exclusion of health services such as education and early screening for EOCRC prevention for the newly identified risk group of young women. To address this unmet need and include young women into the monitoring frameworks of WHO’s framework for strengthening health promotion.