Current international developments in population screening for colorectal cancer

Abstract

Pilot programmes for screening for colorectal cancer in average-risk individuals using faecal occult blood testing are planned to commence in Australia in 2002. The National Cancer Control Initiative was interested to compare Australia's progress in this area with that of other countries. Information on programmes or pilot programmes for colorectal screening in average-risk individuals was sought by letter, fax or email from cancer organizations, government departments and professional bodies in 55 countries worldwide. Based on the responses received (32 replies), no country was identified as having an active programme for colorectal screening for the general population based on the characteristics of identification of eligible subjects, active recruitment and integrated screening and follow up, which would allow determination of the participation rates, detection rate and outcomes such as the stage distribution of cancer. In the United Kingdom a pilot programme is under way to test the feasibility and acceptability of screening for colorectal cancer in the general population using faecal occult blood testing. In Finland, health authorities have agreed that the evidence is sufficient to embark on a pilot programme, and Canada, the Netherlands, Denmark and Switzerland are considering pilot programmes. From our enquiries, in countries using a planned approach, only the UK appears to be ahead of Australia. The British pilots have commenced earlier and are larger and have a shorter time frame than the Australian pilots.