# The Environmental Consequence of Early Colorectal Cancer Detection: A Literature Review of the Environmental Impact Assessment of Colorectal Cancer Diagnostic Pathways

## TL;DR

This paper reviews how different methods for early colorectal cancer detection affect the environment, highlighting the need for standardized assessments.

## Contribution

The paper emphasizes the need for standardized environmental impact assessments in healthcare and highlights the environmental costs of diagnostic methods.

## Key findings

- Population-based screening has a lower environmental impact over time compared to other methods.
- Endoscopy has the highest environmental impact, mainly due to travel by patients and staff.
- Faecal-based tests have the lowest environmental footprint but lack comprehensive pathway assessments.

## Abstract

Background: Colorectal cancer (CRC) is a burden to healthcare globally, with early detection vital to improving outcomes. While screening and early diagnostic strategies are being widely implemented, their environmental impact remains underexplored. The purpose of this literature review is to examine the existing research on the environmental footprint of non-emergency sporadic CRC diagnostic pathways and provide an overview of environmental impact assessment processes. Principal findings: Population-based screening appears environmentally beneficial over time, but its efficiency critically determines its net impact. Studies identify endoscopy as having the highest environmental impact among testing modalities. The dominant contributor to this is patient and staff travel. By contrast, faecal-based tests appear to have the lowest environmental footprint. Notably, pathway-wide assessments are limited, and methodological inconsistencies hinder comparing studies. Conclusions: There is an urgent need to standardise a healthcare sector-specific framework for environmental impact assessments. Emerging biomarker-based diagnostics will require a robust pathway-wide environmental impact assessment before clinical integration.