Bridging healthcare gap: China's subsidized cancer screening reaches millions

Harbin, the capital of Heilongjiang Province of China, launched a three-year public health project offering free screenings for digestive system tumors and chronic diseases, targeting 2.4 million people.

The initiative, in partnership with BGI Genomics and other health organizations, has identified a significant number of high-risk individuals. Positive cases are eligible for subsidized follow-up at designated facilities.

The project uses the more effective, non-invasive stool DNA test, which outperforms the traditional fecal immunochemical test (FIT) in detecting advanced adenomas and identifying high-risk individuals earlier.

High Survival at Early Stage

Over 1.8 million new colorectal cancer (CRC) cases and 881,000 CRC-related deaths were reported globally in 2018, making it the third most common cancer by incidence and the second by mortality. In China, CRC has become a major concern, significantly affecting the population’s quality of life.

Colorectal cancer is often called the "silent killer" due to its hidden early symptoms. The progression from polyps to cancer typically takes 10 to 15 years, offering a window for early intervention, which can result in a high cure rate and a five-year survival rate of over 90%.

Wang Zhe, head of the Endoscopic Diagnosis and Treatment Center at the Third Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, highlights that early screening faces challenges due to lack of awareness and the high cost of colonoscopy. "Many people confuse early symptoms with minor issues like hemorrhoids," says Wang.

Colonoscopy, though accurate, requires fasting, preparation, and can cause discomfort, which deters many. With a large target population and limited qualified endoscopists, particularly in rural areas, traditional methods struggle to meet the screening needs. Delays in diagnosis often lead to more advanced stages of cancer, burdening families and society’s medical resources.

Lowering Screening Barriers

Convenience is key to improving large-scale screening and increasing compliance. The stool DNA test offers a non-invasive, convenient alternative. Samples can be taken at home without special preparation, significantly lowering participation barriers.

Stool DNA methylation testing is more effective than the traditional FIT test in detecting advanced adenomas and identifying high-risk individuals earlier, allowing for preventive treatment.

Global research, including studies from the European Society for Medical Oncology, confirms that stool DNA testing helps target high-risk populations, increasing colonoscopy detection rates. A study in Thailand shows multitarget stool DNA testing's high sensitivity and specificity for detecting CRC.

Health guidelines in many countries, including China, now recommend the "non-invasive primary screening + colonoscopy screening" strategy. This approach improves screening efficiency, optimizes resources, and controls costs by focusing colonoscopy resources on high-risk populations.

Harbin's Real-World Practice

The Harbin CRC screening project targets residents aged 45 to 64. The initiative, accessible via an online platform, is rolled out across more than 300 community health service centers and township health centers in both urban and rural areas.

Stool DNA test kits are provided by BGI Genomics, allowing residents to collect samples at home, which are then sent to community clinics for testing.

The project ensures follow-up management for residents with positive DNA test results. The community hospital contacts those with positive results, assisting them in scheduling colonoscopy appointments and other necessary procedures.

The program also includes subsidies: for those with a positive stool DNA test result, the total cost for colonoscopy and pathological examinations in designated hospitals is capped at 1,200 yuan, all covered by the project's insurance, alleviating the financial burden.

Early Screening, Early Intervention

"I am so lucky," says Aunt Zheng, 60, reflecting on her experience. Due to her family history, she participated in the community screening program. At the end of 2024, her stool DNA test result came back "positive." "At that moment, my heart sank," she recalls.

Despite the timing, just before the New Year, she almost decided to ignore it. Thanks to the persistence of her community family doctor, Aunt Zheng underwent a colonoscopy in late April 2025, revealing 12 large polyps.

Fortunately, all suspicious lesions were removed during the procedure. "If it had been delayed, the consequences could have been disastrous," she reflects.

Now, Aunt Zheng not only follows the doctor's advice for follow-up care but also volunteers as a health promoter in her community. "I hope others can catch problems early, just like I did!"  she says.

The Harbin project has successfully screened a large number of high-risk individuals. Many like Aunt Zheng received timely, effective early diagnosis and treatment through standardized health management and clinical intervention.

This initiative represents a real-world success in applying stool DNA testing for CRC screening, offering a groundbreaking system solution. Its innovative approach to integrating prevention and control of both "tumors and chronic diseases" provides a model for other cities and countries to tackle the growing challenges of chronic non-communicable diseases.

About BGI Genomics

BGI Genomics, headquartered in Shenzhen, China, is the world's leading integrated solutions provider of precision medicine. Our services cover more than 100 countries and regions, involving more than 2,300 medical institutions. In July 2017, as a subsidiary of BGI Group, BGI Genomics (300676.SZ) was officially listed on the Shenzhen Stock Exchange.