Screening in Europe

Colorectal cancer is an alarming worldwide problem with the number of incidences and deaths increasing as a result of the expanding and aging of the population in both developing and developed countries.

In Europe 413,000 people were diagnosed with colorectal cancer and 207,000 died of the disease in 2006 making it the highest incidence cancer and the second-most deadly after lung cancer. Yet colorectal cancer is highly treatable if it is diagnosed early it is in fact the most treatable of all the gastrointestinal cancers. More than 90% of all patients survive if the cancer is diagnosed at an early stage. The problem however is that the majority of colorectal cancers are diagnosed at an advanced stage lowering the chances of survival to less than 10% once the cancer has spread to other organs. These figures clearly demonstrate that early diagnosis can potentially save many lives. Regular and systematic screening has the potential to significantly reduce mortality.

However screening rates are low and many barriers are present that need to be overcome in order to make a major impact on colorectal cancer incidence and mortality in Europe. Despite the EU Recommendations of 2003 stating that “Men and Women from 50 years of age should participate in colorectal cancer screening” population based screening in the EU is still very poor with only Scotland, Finland, UK, Northern Ireland, Wales and Italy having an ongoing population based rollout. In addition where screening is available whether population based or on request compliance is still low.

The debate on which is the most effective screening test continues across the globe. Faecal occult blood testing has the strongest proof of effectiveness based on randomised control trials.

Current colorectal cancer screening programmes in Europe