Limited clinical evidence exists regarding the colorectal cancer screening impact on a patient's daily well-being. Consequently, researchers conducted the large-scale TARGET-C trial in China to evaluate these effects. This multicentre study followed 19,373 participants over a three-year period. The trial compared three primary strategies: one-time colonoscopy, annual faecal immunochemical tests (FIT), and a risk-adapted approach. By using the EuroQol five-dimensional questionnaire, the team tracked changes in health-related utility scores.

Initially, the results showed a very slight decline in utility scores immediately following the baseline screening. Specifically, the change was only -0.008. However, this minor drop proved to be transient. Furthermore, utility scores actually improved during the subsequent follow-up rounds. For instance, the second round saw an increase of 0.007. Similarly, the third round recorded a rise of 0.008. Therefore, while the initial procedure might cause minor stress, the long-term quality of life remains stable for most participants.

Clinical Insights into Colorectal Cancer Screening Impact

Many physicians worry that invasive procedures might deter patients due to psychological distress. Nevertheless, this study demonstrates that various screening modalities produce comparable quality of life outcomes. Whether a patient undergoes a colonoscopy or an annual FIT, their health utility does not suffer long-term damage. In addition, the risk-adapted strategy offers a balanced alternative for high-risk and low-risk populations. Moreover, the upward trend in scores suggests that participants may feel a sense of reassurance after completing multiple screening cycles. Consequently, doctors should confidently recommend these programs to improve early detection rates.

Instead of focusing on short-term discomfort, clinicians should emphasize the long-term benefits of regular monitoring. Because the data shows no significant difference between the three strategies, the choice of test can be tailored to patient preference and local availability. Meanwhile, the mental health benefits of receiving a clear result often outweigh the temporary anxiety of the test itself. Thus, maintaining high adherence remains the most critical factor for successful cancer prevention in primary care settings.

FAQ

What is the initial colorectal cancer screening impact on quality of life?

Research indicates a minimal and non-significant initial decline in utility scores. However, this effect is temporary and typically reverses as patients continue with subsequent screening rounds.

Do different screening methods like colonoscopy or FIT change patient well-being differently?

No, the TARGET-C trial found no significant differences in quality of life changes between colonoscopy, annual FIT, or risk-adapted screening strategies.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or a substitute for professional healthcare consultation. Refer to the latest local and national guidelines for clinical practice.

References

1. Zhou XY et al. Changes in quality of life in colorectal cancer screening: A multicentre trial in populations in China. J Med Screen. 2026 Mar 12. doi: 10.1177/09691413261430309. PMID: 41816867.


2. Chen HD et al. Comparative evaluation of participation and diagnostic yield of colonoscopy vs fecal immunochemical test vs risk-adapted screening in colorectal cancer screening: interim analysis of a multicenter randomized controlled trial (TARGET-C). Am J Gastroenterol. 2020;115(8):1264-1274.


3. Wong MC et al. A validated tool to predict colorectal neoplasia and inform screening choice for asymptomatic subjects. Gut. 2014;63(7):1130-1136.