Page 40 - DIGITAL e-Book RCPH 2026

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1 REGIONAL CONFERENCE onon O r g a n i s e d b y :
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PRECISION HEALTH
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Abstracts for 1st Regional Conference on Precision Health (RCPH)
15-16th April 2026, Royale Chulan Kuala Lumpur
Colorectal Screening: Past, Present, and the Next Decade - From FIT to AI-
Assisted Colonoscopy and Blood-Based Biomarkers
Professor Dr. Rungsun Rerknimitr
Chulalongkorn University, Thailand
ABSTRACT
Current CRC Burden in Thailand:
Colorectal cancer remains a significant public health concern in Thailand, ranking among the top three
cancers. With Thailand's population of 66 million and an aging demographic of 15 million individuals
over age 50, the screening challenge is magnified by severe resource limitations: fewer than 1,000
endoscopists serve the entire nation, creating a critical bottleneck in screening capacity.
Practical Two-Step Screening Strategy:
For resource-limited settings like Thailand, a pragmatic two-step approach is more feasible than
immediate colonoscopy. Risk Stratification : The Asia-Pacific Colorectal Screening (APCS) score
identifies high-risk individuals based on age, gender, family history, and smoking status, enabling
prioritization of colonoscopy resources. FIT-Based Triage : Quantitative FIT at a cutoff of 150 ng/mL
optimizes detection rates while managing endoscopy capacity, achieving 78.6% sensitivity for
colorectal cancer and 17.5% for advanced neoplasia. This combination of clinical risk scoring with FIT
creates a synergistic effect, significantly improving detection efficiency and reducing unnecessary
procedures.
AI-Assisted Colonoscopy: CADe and CADx:
Artificial intelligence technologies are revolutionizing colonoscopy quality:
Computer-Aided Detection (CADe) improves adenoma detection rates, particularly benefiting less
experienced endoscopists. Studies demonstrate that AI-assisted systems significantly enhance
detection even among highly skilled practitioners. Computer-Aided Diagnosis (CADx) predicts polyp
histology in real-time, enabling the "leave-in-situ" or "resect-and-discard" approach for diminutive
lesions. This supports the Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI)
protocol, reducing unnecessary procedures while maintaining diagnostic accuracy.Blood-Based
Biomarkers and Emerging Technologies.