Lansdorp-Vogelaar I, Meester R, de Jonge L, et al. - Simply implementing risk-based screening based on age, gender, and prior screening history would be a significant improvement over current uniform screening methods. The authors believe that screening programs should begin there and work their way up to more comprehensive approaches that include primary prevention as an effective way to reduce the risk for everyone.

• In an ideal world, screening would be limited to the small percentage of the population that could benefit.

• By redistributing screening resources from low-risk to high-risk individuals, risk-based screening can be viewed as the first step toward this ideal world.

• In theory, this should result in scarce resources being directed toward those who benefit the most, while screening intensity is reduced for those who benefit the least, thereby improving the benefit-harm ratio for all invitees.

• Risk-based colorectal cancer screening strategies that have been proposed include using information on age, gender, prior screening history, lifestyle, and/or genetic information.

• Implementing risk-based screening necessitates careful consideration of reliable risk prediction models, screening participation, and informed decision making.

• While it is critical to acknowledge the limitations of current approaches, available evidence suggests that it may be possible to begin planning the implementation of tailored strategies within screening programs.