Abstract
WHAT IS ALREADY KNOWN ON THIS TOPIC? China has the world's largest population of individuals who are overweight or obese, contributing to the growing burden of colorectal cancer (CRC). Screening is an effective strategy for reducing CRC mortality and incidence. WHAT IS ADDED BY THIS REPORT? Using a simulation model, we found that CRC screening reduces incidence and mortality across all body mass index groups (normal, overweight, and obese) in China, with greater quality-adjusted life-year gains and 6%-14% higher colonoscopy efficiency in individuals who are overweight or obese. Screening proved to be more cost-effective for these groups, despite high lifetime healthcare expenditures. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE? CRC screening in China can prioritize populations with excess weight and incorporate weight management to improve health outcomes and control long-term healthcare costs.