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Open research questions in Colorectal Cancer Screening and Detection

507 gap statements mined from Colorectal Cancer Screening and Detection papers in our 7.9M-paper local library, which holds 2,841 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • The study faced challenges in evaluating the clinical utility of FOBT in hospitalized patients due to limited evidence. The study had to account for differential endoscopic verification in assessing the association between FOBT and endoscopic findings. The study identified the challenge of inappropriate FOBT utilization in hospitalized patients despite current clinical guidelines.

    Diagnostic Indications and Endoscopic Correlates of Fecal Occult Blood Testing in Hospitalized Patients · 2026 · DOI

  • The relative contributions of changing lifestyles, metabolic health, environmental exposures, and other early-life risk factors to the increasing incidence of early-onset colorectal cancer remain incompletely understood. The heterogeneity in the definition of early-onset colorectal cancer complicates direct comparison between studies.

    The Changing Global Epidemiology of Early-Onset Colorectal Cancer: Incidence Trends, Modifiable Risk Factors, and Future Burden Projections · 2026 · DOI

  • The study is based on retrospective analysis of existing data. The analysis is limited to adults aged 20 years and older. The study does not account for potential biases in data collection and reporting.

    Colorectal Cancer in the U.S., 1999–2021: Declining Rates, Rising Concerns, and Persistent Disparities · 2025 · DOI

  • Population-level mortality-to-incidence patterns remain under-characterized. Prior studies rarely evaluate how mortality tracks incidence within groups over time. There is a need for a comprehensive analysis of colorectal cancer trends in the US, including examination of disparities by age, sex, race/ethnicity, and geography.

    Colorectal Cancer in the U.S., 1999–2021: Declining Rates, Rising Concerns, and Persistent Disparities · 2025 · DOI

  • There is a gap in understanding the association between CRC incidence and exposure to different risk factors or protective factors. Further studies, especially randomized, controlled trials, are needed to clarify this association. There is a need to identify and avoid modifiable risk factors, especially lifestyle factors, and to increase protective factors.

    Colorectal Cancer: Epidemiology, Risk Factors, and Prevention · 2024 · DOI

  • The classification and clinical implications of colorectal intramucosal adenocarcinoma remain controversial.

    Quo Vadis colorectal intramucosal adenocarcinoma? · 2026 · DOI

  • Whilst CADe has been shown to improve adenoma detection rate (ADR) in average-risk screening populations, its role in FIT-positive colonoscopy remains uncertain.

    Artificial Intelligence in FIT‐Positive Colonoscopy: Balancing Detection Metrics and Clinical Impact · 2026 · DOI

  • The risk of colorectal cancer (CRC) after serrated polyp resection remains unclear, and current surveillance recommendations rely on limited evidence.

    Long‐Term Colorectal Cancer Incidence After Adenoma and Serrated Polyp Removal: Results From the Colonprev Trial · 2026 · DOI

  • Pediatric data remain limited, with no studies specific to hereditary polyposis syndromes, but early studies support feasibility.

    Artificial intelligence in pediatric endoscopy for hereditary polyposis syndromes: promises and challenges · 2026 · DOI

  • In adult colonoscopy, meta-analyses and randomized trials demonstrate that artificial intelligence improves adenoma detection rates (ADR) and reduces missed lesions, though evidence linking these benefits to meaningful reductions in colorectal cancer incidence remains insufficient.

    Artificial intelligence in pediatric endoscopy for hereditary polyposis syndromes: promises and challenges · 2026 · DOI

  • Key precursors include sessile serrated lesion (SSL) and SSL with dysplasia (SSLD); traditional serrated adenoma, and also the recently described superficially serrated adenoma which warrants attention.

    Endoscopic Assessment and Management of Colorectal Serrated Lesions: Current Comparative Practice, Challenges, and Future Directions · 2026 · DOI

  • Endoscopic resection (ER) is well established for serrated lesions in patients with noninflammatory bowel disease; however, limited evidence supports its outcomes in patients with ulcerative colitis (UC).

    Short‐ and Long‐Term Outcomes of Endoscopic Resection for Serrated Lesions in Patients With Ulcerative Colitis: A Retrospective Exploratory Study · 2026 · DOI

  • In addition, standardized diagnostic criteria for serrated lesions in UC have not yet been fully established.

    Serrated Lesions in Ulcerative Colitis: Beyond Endoscopic Resection · 2026 · DOI

  • The environmental impact of cold snare polypectomy compared with hot snare polypectomy for diminutive and small polyps has not been assessed.

    Universal Cold Snare Polypectomy for Small and Diminutive Colonic Polyps—Sustainability Matters · 2026 · DOI

  • Ulcerative colitis (UC)-associated neoplasia (UCAN) carries a risk of metachronous development; however, risk stratification based on inflammatory origin remains unclear.

    Long‐Term Outcomes After Endoscopic Resection for Strictly Defined Ulcerative Colitis‐Associated Neoplasia: An Exploratory Retrospective Cohort Study · 2026 · DOI

  • Current surveillance recommendations for SSLs are gradually becoming more explicit across regions; however, these recommendations are largely extrapolated from studies of conventional adenomas and mixed-age populations, and elderly-specific evidence remains limited.

    Management of Colorectal Sessile Serrated Lesions in Elderly Patients · 2026 · DOI

  • Image-enhanced endoscopy (IEE) technologies have been developed to improve colorectal polyp detection, but their comparative efficacy remains uncertain.

    Comparative Performance of Image‐Enhanced Endoscopy for Adenoma and Sessile Serrated Lesion Detection: A Network Meta‐Analysis · 2026 · DOI

  • There is limited information on the positive predictive value (PPV) of symptoms as indicators of early-onset colorectal cancer.

    Positive Predictive Value of Symptoms for Early-Onset Colorectal Cancer · 2026 · DOI

  • IMPACT: Future research is needed to develop high PPV strategies for identifying early-onset colorectal cancer without compromising sensitivity.

    Positive Predictive Value of Symptoms for Early-Onset Colorectal Cancer · 2026 · DOI

  • Capsule colonoscopy (CC) and pan-intestinal capsule endoscopy ("panendoscopy") require effective bowel cleansing; however, evidence on ultra-low-volume regimens is lacking.

    Efficacy of 1 L PEG Ascorbate vs Sodium Picosulfate With Magnesium Citrate Bowel Preparations for Capsule Colonoscopy and Pan-Intestinal Capsule Endoscopy: A Prospective Study · 2026 · DOI

  • Glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy has been associated with inadequate bowel preparation (IBP) during colonoscopy, but the role of baseline body mass index (BMI) remains unclear.

    Body Mass Index-Dependent Effect of Glucagon-Like Peptide 1 Receptor Agonist Therapy on Bowel Preparation Quality · 2026 · DOI

  • The performance of CAD-EYE was insufficient for the characterization of neoplastic colonic polyps.

    Real-Time Characterization of Colonic Polyps: A Multicenter Prospective Study Evaluating the CAD-EYE System in Screening Colonoscopies · 2026 · DOI

  • Further studies are needed to evaluate the clinical utility of FOBT in hospitalized patients, - Research should focus on the appropriate use of FOBT in different clinical scenarios, - Studies should investigate the impact of FOBT on patient outcomes and healthcare resource…

    Diagnostic Indications and Endoscopic Correlates of Fecal Occult Blood Testing in Hospitalized Patients · 2026 · DOI

  • Further study of the relative contributions of changing lifestyles, metabolic health, environmental exposures, and other early-life risk factors - Investigation of the effects of demographic change, evolving exposure patterns, changes in diagnostic practices, and the persistence or modification of cohort-specific…

    The Changing Global Epidemiology of Early-Onset Colorectal Cancer: Incidence Trends, Modifiable Risk Factors, and Future Burden Projections · 2026 · DOI

  • Inconsistent findings for the association between psychological stress and CRC risk, - Differences in definitions and methods for measuring stress levels, - Limited data on the association between sedentary lifestyle and CRC…

    Colorectal Cancer: Epidemiology, Risk Factors, and Prevention · 2024 · DOI

Most-cited papers in Colorectal Cancer Screening and Detection

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Open questions raised by papers listed on this page include: (1) The relative contributions of changing lifestyles, metabolic health, environmental exposures, and other early-life risk factors to the increasing incidence of early-onset colorectal cancer remain incompletely understood (“The Changing Global Epidemiology of Early-Onset Colorectal Cancer: Incidence…”, 2026); (2) The classification and clinical implications of colorectal intramucosal adenocarcinoma remain controversial (“Quo Vadis colorectal intramucosal adenocarcinoma?”, 2026); (3) The risk of colorectal cancer (CRC) after serrated polyp resection remains unclear, and current surveillance recommendations rely on limited evidence (“Long‐Term Colorectal Cancer Incidence After Adenoma and Serrated Polyp Removal:…”, 2026); (4) Pediatric data remain limited, with no studies specific to hereditary polyposis syndromes, but early studies support feasibility (“Artificial intelligence in pediatric endoscopy for hereditary polyposis…”, 2026); (5) Standardized diagnostic criteria for serrated lesions in UC have not yet been fully established (“Serrated Lesions in Ulcerative Colitis: Beyond Endoscopic Resection”, 2026). 507 gap statements have been mined from Colorectal Cancer Screening and Detection papers in our 7.9M-paper local library, which holds 2,841 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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