Colorectal cancer screening by means of repeated faecal immunochemical testing (FIT)

Abstract

Colorectal cancer (CRC) is a major health concern. Approximately 1.2 million people are diagnosed with CRC each year worldwide. The disease thus accounts for almost 10% of all cancers. The highest incidence rates are seen in the Western world, including Europe, the USA, Australia, and New Zealand [2]. The lowest incidence rates are found in Africa and South-Central Asia. The geographic differences appear to be attributable to differences in dietary and environmental exposures. The lifetime incidence of CRC in patients at average risk is about five percent [1]. Rates are substantially higher in men than in women. In the USA for example, the incidence of CRC is about 25% higher in men than in women. Common risk factors and potentially modifiable behaviours include physical inactivity, obesity, and smoking, as well as having a first-degree relative with CRC. Age is also a major risk factor for CRC. Before the age of 40 years CRC is uncommon, except in patients with a genetic predisposition [7, 8]. Beyond the age of 50 years incidence rates rapidly increase [2]. Sporadic CRC thus typically affects men and women between the ages of 55 and 85 years. This group consists of approximately 80% of CRC patients.