Implementation of a national colorectal cancer screening program

There is no direct evidence that colonoscopy screening reduces mortality from colorectal cancer. However, results from studies using fecal occult blood testing and sigmoidoscopy, along with the fact that colonoscopy is performed after positive primary screening tests, support this assumption. Colonoscopy every 10 years is the preferred strategy in terms of clinical outcomes and cost effectiveness. The purpose of this article is to present the methodology used for the implementation of an opportunistic colonoscopy colorectal cancer screening program in Poland. We also review recent literature on challenges related to colonoscopy screening including recruitment, acceptance, and quality of the procedure.