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. 2024 Apr 29;41:100920. doi: 10.1016/j.lanepe.2024.100920

Table 2.

Classification of EHIS-participating countries by type of CRC screening programs.

Country Structure of screening program Year of program initiation (& possibly, termination) Age group Type of screening test Screening interval Referenceh Category according to gFOBT/FIT offer
Belgium (Flemish region) Organized 2013–2018 56–74 FIT 2 yrs 1,2 A
2018–2020 53–74
2020 50–74
Belgium (Wallonia/Brussels) 2009–2016 50–74 gFOBT
2016 FIT
Croatia Organized 2007 50–74 gFOBT 2 yrs 3–5
Denmark Organized 2014 50–74 FIT 2 yrs 6
Lithuania (Vilnius and Kaunas) Organized 2009–2014 (pilot) 50–74 FIT 2 yrs 7,8
Lithuania (All regions) 2014
The Netherlands Organized 2014 55–75 FIT 2 yrs 9
Slovenia Organized (pilot) 2008–2009 50–69 FIT 2 yrs 10,11
Organized 2009–2015 50–74
2015
Czechia Organized (pilot) 1979–1998 45–60 gFOBT 2 yrs 12–15 B
Opportunistic 2000–2009 50–54
Opportunistic 2009 50–54 FIT/Colo 1 yr
Opportunistic 2009 55+ FIT/Colo 2 yrs/10 yrs
Organized 2014 50+ FIT 2 yrs
Finlanda Organized 2004–2016 60–69 gFOBT 2 yrs 16,17
Organized (pilot) 2019–2027 56–74 FIT
Hungary (Csongrád county) Organized 2013–2015 50–70 FIT 2 yrs 18,19
Hungaryb Organized 2018
Ireland Organized 2012 55–74 FIT 2 yrs 3,20,21
Italy Organized 1982–1996 50–69 gFOBT 2 yrs 22–24
Organized 1996 50-70/74 FIT
Italy (Piedmont and Veneto regions) Organized 2003/2004 58–60 FS Once only
Malta Organized 2012 55–66 FIT 2 yrs 5,25
NR 55–74 2 yrs
Portugal Opportunistic NR 50–74 FIT/Colo 1 yr/10 yrs 12,26–28
Portugal (Alentejo and Central regions) Organized 2009–2018 50–70 gFOBT 2 yrs
2018 FIT
Portugal (Northern region) Organized (pilot) 2016–2018 50–74 FIT
Organized 2018
Serbia (32 municipalities) Organized 2013–2014 50–74 FIT 29,30
Spain Organized 2000–2010 50–69 gFOBT 2 yrs 3,12,31–33
2010 FIT
Sweden (Regions Gotland and Stockholm) Organized 2008–2015 60–69 gFOBT 2 yrs 5,24,34
2015 FIT
Sweden (Region Skåne) 2021 60–74 FIT
Austria (Burgenland) Organized 2003 40–80 FIT 1 yr 24,35 C
Austria (Vorarlberg)c 2007 50+ Colo 10 yrs
Austria (All regions) Opportunistic 1980 40+ gFOBT, 1 yr
2005 50+ Colo 7–10 yrs
Germany Opportunistic 1977–2002 45+ gFOBT 1 yr 36–38
Opportunistic 2002–2017 50–54 gFOBT 1 yr
2017 FIT
Opportunistic 2002–2017 55+ gFOBT/Colo 2 yrs/10 yrs
2017 FIT/Colo
Organized 2019 50-54/55+ FIT 1 yr, then 2 yrly
Organized 2019 50+(men); 55+(women) Colo (up to 2 screenings) 10 yrs
Greece Opportunistic NR 50–74 gFOBT NR 3,33
Colo NR
Latvia Opportunistic 2005 50–74 gFOBT 1 yr 3,39
Slovakia Opportunistic 2002–2019 45–75 gFOBT/Colo 2 yrs 40
Organized (pilot) 2019–2021 50–75 FIT
Organized 2021 FIT
Bulgariad Opportunistic 2009 NR gFOBT NR 41 D
No program 2009 NA NA
Cypruse No program NA NA NA NA 42
Estoniaf Organized (Pilot) 2016 60–69 FIT 2 yrs 43,44
Organized 2022
Iceland Opportunistic NR 50+ Colo NR 45
Luxembourg Opportunistic 2005- 50+ gFOBT/Colo NA 12,46
Organized (Pilot) 2016–2019 55–74 FIT/Colo 2 yrs/10 yrs
Organized 2021 FIT 2 yrs
Norway (Østfold, Akershus & Buskerud Counties) Organized (pilot) 2012–2018 50–74 FS/FIT 2 yrs (FIT), Once (FS) 47–50
Norway (All regions)g Organized 2022 55+ FIT 2 yrs
Poland Opportunistic 2000–2011 50–66 Colo 10 yrs 51–53
Poland (25 of 380 counties) Organized (pilot) 2012 55–64 Colo Once only
Romania No program NA NA NA NA 54

The countries are arranged in alphabetical order within each category based on the type of CRC screening programs offered with regards to fecal tests. Category A, countries with nationwide organized screening fully implemented using fecal tests; Category B, countries with organized programs with fecal tests partially rolled out or with regional coverage only; Category C, countries with opportunistic programs with fecal test; category D, countries with no program with fecal tests or a small-scale pilot program only.

gFOBT, guaiac-based fecal occult blood test; FIT, fecal immunochemical test; FS, flexible sigmoidoscopy; Colo, colonoscopy; NA, not applicable; NR, not reported; yr(s), year(s).

a

In Finland, following the pilot of FIT in 2019–2021 in volunteer municipalities, the Government Decree on Screenings was amended to make screening available nationwide from 2022 onwards. Screening every 2 years was initially introduced among 60–68-year-olds and will be expanded to all target age groups (56–74) by 2031 (https://cancerregistry.fi/screening/colorectal-cancer-screening/).

b

In Hungary, eligible persons are invited by the National Public Health Institute based on their association with GPs who are participating in the screening program. The GPs are reimbursed per screened individual (Supplementary Item S6, ref. 19).

c

In Vorarlberg, screening is only available for insured individuals according to the protocol (Supplementary Item S6, ref. 24).

d

In Bulgaria, general practitioners (GPs) were responsible for the referral of patients for gFOBT until 2009, when the opportunistic program was discontinued due to poor compliance by both the practitioners and the eligible persons (Supplementary Item S6, ref. 41).

e

In Cyprus, a small-scale pilot program was said to have been conducted in 2013; however, no further information has been provided about the continuation of any screening program since then.

f

In Estonia, an organized screening program was piloted among insured persons from 2016 until 2022, when it was expanded to all eligible individuals.

g

In Norway, organized screening with FIT was piloted between 2012 and 2018 in Østfold, Akershus, and Buskerud Counties. Since May 2022, the Norwegian Cancer Registry has administered a nationwide CRC screening with FIT every 2 years from age 55. The program is expected to be replaced with a once-only screening colonoscopy after five FIT screening rounds, when colonoscopy capacity would have improved to cover the entire target population (Supplementary Item S6, ref. 47).

h

Reference list for Table 2. See Supplementary Item S6 in the Supplementary document.