Screening for colorectal cancer
Wiener klinische Wochenschrift · 2023 · Austria
Source and licence
- Authors
- Gerald Gartlehner, Eva Schernhammer, Sigurd F Lax et al.
- Title
- Screening for colorectal cancer
- Journal
- Wiener Klinische Wochenschrift, 2023
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC10497440
Licence statement of the original publication
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This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.
Open the original publication →Full text on Europe PMC
Recommendations
Verbatim, with grade of recommendation or strength of consensus where given.
Recommendation statements
- The ANCCS recommends a quality-assured colorectal cancer screening program with colonoscopy or FIT for individuals aged 45–75 years. In persons 65 years or older, screening decisions should occur on an individual basis in accordance with a person’s overall health, prior screening history, and preferences. Both screening strategies are considered equivalent, and citizens should be able to make an informed decision about their preferred method. Switching between the two screening strategies should be possibleA recommendation, moderate evidence
- In persons with unremarkable screening results, the ANCCS recommends that colonoscopy screening should be repeated every 10 years and screening with FIT every 2 years. Persons who have had a colonoscopy screening do not need to be screened with a FIT for another 10 yearsA recommendation, moderate strength of evidence
- For individuals with pre-existing conditions associated with an increased risk of colorectal cancer (e.g., ulcerative colitis or Crohn’s disease, or in the case of relatives with familial colorectal cancer syndrome), recommendations for colorectal cancer screening differ. Participation in the screening program is possible, but not recommended. These individuals should receive special screening recommendations in specialized centers, according to their diseases, medical history and increased risk. This also applies to individuals already being treated for colorectal cancer. In these cases, an individual decision regarding screening should be made in consultation with the treating physician, according to clinical practice guidelines (good practice statement).
- The ANCCS recommends accompanying the implementation and ongoing operation of a screening program for colorectal cancer with a public information campaign, systematic data collection, quality assurance, and program evaluation. Furthermore, the ANCCS recommends establishing a strategic steering group and a project steering committee for the implementation of the screening program (taking into account layperson-oriented information and communication) and its documentation, quality assurance, and evaluation (good practice statement).
- The ANCCS recommends the implementation of an organized colorectal cancer screening program for all adults aged 45–75 yearsStrength of recommendation: A (moderate evidence)
- The ANCCS recommends screening with colonoscopy (every 10 years) or fecal immunochemical test (FIT) every 2 years. Persons who have had a colonoscopy screening do not need to be screened with FIT for the next 10 yearsStrength of recommendation: A (moderate evidence)
Abstract
Background: Colorectal cancer is the fourth most common cancer in Austria. To date, colorectal cancer screening in Austria remains opportunistic and includes colonoscopy or stool-based blood tests. The Austrian National Committee for Cancer Screening developed evidence-based recommendations for a nationwide organized colorectal cancer screening program.
Methods: The methodological framework followed the approach of the United States Preventive Services Task Force. The evidence base underlying the newly developed recommendations comprised a review of the existing published evidence and a decision analytic model tailored to the Austrian context. Using a structured process, committee members considered 1) the magnitude of the net benefit of each screening strategy, 2) the certainty of evidence, and 3) the level of acceptance of the interventions among the target population.
Recommendations: The Austrian National Committee for Cancer Screening recommends the implementation of a nationwide organized colorectal cancer screening program for all adults aged 45–75 years. For persons 65 years or older, screening decisions should occur on an individual basis in accordance with a person’s overall health, prior screening history, and preferences.
Specifically, the committee recommends either a 10-year screening colonoscopy or biennial fecal immunochemical tests with colonoscopy following a positive result, with both screening strategies considered equivalent. Each citizen should be able to make an informed decision about their preferred screening method. Switching between the two screening strategies should be possible. Following an unremarkable colonoscopy, screening by fecal immunochemical test (FIT) is only required after 10 years. Screening recommendations apply only to asymptomatic persons at average risk for colorectal cancer.
The screening program must be pilot tested, and accompanied by a public information campaign, formative evaluation, quality assurance, and data collection.
Contents of the original publication
The section headings of the original.
- Introduction
- Colorectal cancer burden in Austria
- Current colorectal cancer screening methods in Austria
- The Austrian National Committee for Cancer Screening (ANCCS)
- Objective and target population
- Methods
- Topic refinement
- Evidence review
- Assessing the net benefit of the screening intervention
- Development of recommendations
- Review of draft recommendations
- Recommendation statements
- Summary of the supporting evidence
- Stool-based tests
- Colonoscopy
- Comparative effectiveness of stool-based tests and colonoscopy
- Practical implications
- Contributor Information
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