Globally, colorectal cancer (CRC) is one of the most common causes of morbidity and deaths. It is highly preventable and beatable by lifestyle modification and its screening. Existing literature has demonstrated the effectiveness of CRC screening in reducing its mortality in the general population, especially among subjects aged 50 years or above. In Asia Pacific countries, the use of Faecal occult blood test (FOBT) is the most commonly observed in primary care for population-based screening. Its popularity is due to its affordability, convenience, user-friendliness, and higher cost-effectiveness when applied to the general population.  Nevertheless, it is relatively insensitive to detect advanced or non-advanced adenomas. In qualitative research, this has been quoted as one of the most common reasons for programme non-participation. Furthermore, the utilization of colonoscopy as an initial screening modality is rather unrealistic in countries and regions with limited colonoscopy capacity.
There is a surge of academic research with an increasing number of publications on the adoption of non-invasive biomarkers for screening of CRC and its precursor lesions. These consist of genetic tests such as DNA, microRNA, protein and metabolites, in addition to epigenetic hypermethylation markers. Also, a recent breakthrough in the application of microbiota has emerged, and this includes Fusobacterium nucleatum. Lachnoclostridium spp m3, Clostridium hathewayi, and Bacteroides clarus. This speech aims to present an update on these non-invasive biomarkers and their potential application in the general public. Their inclusion in territory-wide screening programmes and future research perspectives will also be highlighted.

Professor Martin Chi Sang Wong
BMedSc (Hons), MSc (Hons), MBChB, MD (CUHK), MPH, MBA, FRACGP, FRSPH, FHKCFP, FHKAM (Fam Med), DCH (Ire), FESC, FACC, FAcadTM, FFPH, FHKAN (Hons), FRCP (Glasgow), FRCP (Edinburgh)
Professor, JC School of Public Health and Primary Care, Faculty of Medicine; 
Professor (by courtesy), Department of Sports Science and Physical Education, The Chinese University of Hong Kong
Adjunct Professor, School of Public Health, Peking Union Medical College
Adjunct Professor of Global Health, School of Public Health, Peking University
Professor Martin C. S. Wong is a specialist in Family Medicine and a researcher in the field of cancer screening and prevention of chronic diseases. Professor Wong has composed over three hundred publications in international peer-reviewed journals, and received over 15 research awards for studies in his research area, including the prestigious “1st Distinguished Research Making Family Medicine Shine Award” by the World Organization of Family Doctors in 2018. He is the Co-Chair of the NCD stream of APRU Global Health Programme; Co-Chairman of the Grant Review Board, Health and Medical Research Fund, Food and Health Bureau (FHB); the Convener of the Advisory Group on Hong Kong Reference Framework for Care of Diabetes and Hypertension in Primary Care Settings; a member of the Expert Advisory Panel in Implementation Science of the HKSAR government, and a member of the Research Council of the FHB. He is a reviewer of the Medical Research Council (MRC), United Kingdom; expert reviewer of the National Medical Research Council (NMRC), Singapore; external examiners of doctoral thesis in various Universities; and an external reviewer of the Public Policy Research Funding Scheme, Research Grant Council (RGC) of Hong Kong. His enthusiasm to teaching has been well received by students and has been selected for the “Master Teacher” and the “Annual Teacher of the Year Award” for seven years.
In 2016, he was conferred as an Honorary Fellow by the Hong Kong Academy of Nursing to recognize his achievements in the profession and contributions to primary care. He was appointed as the Editor-in-Chief of the Hong Kong Academy of Medicine in 2017; and Fellows of various Academies, Royal Colleges and professional societies. He was appointed as an Adjunct Professor of the Peking Union Medical College in March 2019; and Adjunct Professor of Global Health by the Peking University.