Twenty-Five Years of Colorectal Cancer Screening in the Czech Republic: National Registry Trends in Program Performance and Cancer Burden
TL;DR
Since the national screening program was launched in 2000, age-standardized incidence has fallen by about 32% and mortality by about 50% and the contribution of screening to this decline cannot be determined.
Abstract
Simple Summary Colorectal cancer has been one of the greatest cancer burdens in the Czech Republic for decades, with incidence and mortality among the highest recorded worldwide. Introduced in 2000, the national screening program was initially opportunistic and later transformed into population-based screening. Registry data described program performance in 2006–2025, and national incidence and mortality in 1977–2024. Among 653,825 preventive colonoscopies, at least one adenoma was detected in 251,974 examinations and cancer, including carcinoma in situ, in 16,575. Stage was recorded for only part of the cancers detected, so no conclusion can be drawn about a shift towards earlier stages. Since the program was launched in 2000, age-standardized incidence has fallen by about 32% and mortality by about 50%. Because individual screening histories were not linked to cancer outcomes, the contribution of screening to this decline cannot be determined. In 2025 one third of the target population was covered by screening, and 58% of people with a positive test had a follow-up colonoscopy within six months. Raising participation and shortening that wait are the program’s main challenges.