Screening process

All asymptomatic men and women aged over 50 years are eligible for colorectal cancer screening in the Czech Republic. Those individuals who meet the criteria of high-risk groups for colorectal cancer are not eligible for the screening programme. Special surveillance regimes exist for patients with positive personal or family history of colorectal cancer, adenomatous polyps, familial adenomatous polyposis (FAP), hereditary nonpolyposis colorectal cancer (HNPCC), or inflammatory bowel disease (IBD).

Two screening options are available:

1. repeated FOBT,
2. screening colonoscopy as an alternative screening option.

1. FOBT

In case of a negative test result (FOBT-):

• FOBT is repeated each year in persons aged 50–54 years,
• FOBT is repeated every two years in persons aged over 55 years.

In case of a positive test result (FOBT+), screening colonoscopy is indicated.

2. Screening colonoscopy

Screening colonoscopy is an alternative screening option for those individuals who decided not to undergo FOBT. This examination is reimbursed from the public health insurance for individuals aged over 50. The screening colonoscopy is indicated by a GP or by a endoscopist from a respective health care facility. If the examination is indicated by a endoscopist, he/she is obliged to inform the respective GP about this fact.

In case of a negative result of screening colonoscopy, another colonoscopic examination is indicated after a 10-year interval.

In case of a positive result of screening colonoscopy, further diagnostic and therapeutic procedures follow the recommendations for patients at a high risk of colorectal cancer.

Each participant of the screening programme, who wants the findings by one health care facility to be consulted or verified by another health care facility in an interval shorter than recommended by a doctor or the screening programme, has to pay for this examination (i.e., it is not reimbursed from the public health insurance).