Colorectal cancer screening

Screening for colorectal cancer was started in Finland in 2004. In 2014, there were 170 municipalities involved in screening, which covered almost half of the target population.

In the study, half of men and women aged 60-69 years were invited to take part in screening, while half were a control group who did not receive the screening invitation. As a screening test, the guaiac-based faecal occult blood test (gFOBT) was used as a screening test.

Some 70 % of those invited attended the screening, or sent a faecal sample to the screening laboratory. Three hundred of those who participated in the screening were referred for further examination, i.e. colonoscopy. Cancers or severe precursors were found in about one in ten colonoscopies (link to statistics).

An interim report was published in 2015 to examine the effect of screening on colorectal cancer mortality (2. Pitkäniemi et al., 2015). There was no difference between people invited and those not invited for screening, after the average monitoring period of 4.5 years. Colorectal cancer mortality among men invited for screening was lower and among such was women higher than their non-screened control group.

The screening programme is currently suspended. No new people are being invited to take part in the screening programme, but the follow-up monitoring of those who were invited to and who took part in the programme continues.

The European Union recommends the use of colorectal cancer screening by its member states (3. European Colorectal Cancer Screening Guidelines Working Group 2013). New screening programmes have been launched in the Netherlands and in other Nordic countries, for example. Finland should also consider initiating a screening programme for colorectal cancer by replacing the test with a better and more research-validated immunochemical test (FIT). In addition, the previously observed mortality gap between men and women needs to be investigated.

  1. Malila N, Anttila A, Hakama M. Colorectal cancer screening in Finland: details of the national screening programme implemented in Autumn 2004. J Med Screen 2005; 12: 28–32.
  2. Pitkäniemi J, Seppä K, Hakama M ym. Effectiveness of screening for colorectal cancer with a faecal occult-blood test, in Finland. BMJ Open Gastro 2015; 2: e000034.
  3. European Colorectal Cancer Screening Guidelines Working Group. European guidelines for quality assurance in colorectal cancer screening and diagnosis: overview and introduction to the full supplement publication. Endoscopy 2013; 45: 51-9.