A colorectal cancer (CRC) screening initiative launched in Harbin, Heilongjiang province, China, in March 2024 has attracted about 830,000 participants for registration, demonstrating significant community engagement. The project, targeting 2.4 million residents aged 45 to 64 over three years, utilizes fecal DNA methylation testing technology from BGI Genomics to identify at-risk individuals efficiently.

Figure 1. Residents sign up for colorectal cancer screenings in the community.

The screening aims to reduce unnecessary colonoscopies and make screening accessible to a broader population. Residents with positive results are eligible for colonoscopies and future pathological examinations at designated hospitals within a year, with costs under US$165 covered by the program. This approach ensures affordable access to necessary procedures and reduces the strain on medical resources, making the model suitable for regions with limited healthcare capacity.

Since its launch, the Harbin screening project has gained significant traction. By January 20, about 830,000 residents had registered for the program, and over 750,000 screening reports had been issued.

Figure 2. A community hospital in Harbin registering residents for colorectal cancer screenings.

This large-scale initiative marks a significant step in China’s efforts to combat colorectal cancer, employing a tiered screening approach that has gained attention globally. Many regions in China have adopted a tiered screening strategy to reduce the burden of CRC, inspiring global CRC prevention and control. The tiered screening approach involves using methods like fecal DNA testing or FIT to assess CRC risk, followed by precise screening with colonoscopy for high-risk individuals. This approach reduces unnecessary colonoscopies, making it suitable for regions with constrained medical resources.

Early detection of CRC enables less invasive treatment, resulting in lower morbidity, mortality, and treatment costs. Fecal DNA testing, a noninvasive method, has boosted CRC early-screening participation rates, with studies suggesting up to 70% compliance compared to colonoscopy alone.

The Harbin initiative is the largest public CRC screening project of its kind in China that utilizes fecal DNA methylation testing for organized efforts. The technology targets genetic mutations and methylation characteristics of colorectal cells, requiring no special equipment, dietary restrictions, or invasive procedures. It has been included in CRC screening guidelines and expert consensus globally. This initiative underscores the importance of early detection and the potential for cost-effective healthcare solutions that could be adapted worldwide.

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