The National Colorectal Cancer Screening Programme in the Czech Republic: changes in 2026–2027

Czech version

Authors: Š. Suchánek ^1,2 ; L. Hrdlička ³ ; R. Chloupková ^4,5 ; K. Hejduk ^4,5 ; I. Tachecí ⁶ ; M. Hajdúch ^7,8 ; T. Hauer ⁸; L. Dušek ^4,5 ; M. Zavoral ^1,2 ; O. Májek ^4,5
Authors‘ workplace: Interní klinika 1. LF UK a ÚVN – VFN Praha ¹; Ústav gastrointestinální onkologie, ÚVN – VFN Praha ²; ResTrial GastroEndo s. r. o., Praha ³; Institut biostatistiky a analýz, Lékařská fakulta MU, Brno ⁴; Národní screeningové centrum, Ústav zdravotnických informací a statistiky České republiky, Praha ⁵; II. interní gastroenterologická klinika LF UK a FN Hradec Králové ⁶; Ústav molekulární a translační medicíny LF UP a FN Olomouc ⁷; Ministerstvo zdravotnictví České republiky, Praha ⁸
Published in: Gastroent Hepatol 2026; 80(5): 399-408
Category: Gastrointestinal Oncology: Review Article
doi: https://doi.org/10.48095/ccgh2026399

Overview

The Czech National Colorectal Cancer (CRC) Screening Programme is undergoing its most substantial change since the introduction of personal invitations in 2014. From January 1, 2026, the target population is defined as ages 45 to 74 years, replacing the previous lower bound of 50 years with no upper limit. From January 1, 2027, a set of amendments to the List of Health Services is due to follow. The existing non-screening colonoscopy procedure 15404 will be abolished and split into four procedures distinguished by indication and by macroscopic findings. A signal procedure corresponding to the determined surveillance interval will be reported after every colonoscopy, and after a colonoscopy in which neoplasia is detected and the tissue is sampled, a new clinical procedure for review of the histology results will be reported first. The point value for preventive colonoscopies is set to increase by 21%. The amendments are intended to distinguish colonoscopies more precisely by indication and finding and to shift capacity gradually towards preventive procedures without reducing the throughput of the system. The optimisation was initiated by the Ministry of Health. The amendments were designed by the Society for Gastrointestinal Oncology and the Czech Society of Gastroenterology, and the National Screening Centre prepared the capacity and cost model. The proposal was discussed by the Ministry of Health Committee for the CRC screening programme, and the procedures were approved by the Working Group on the List of Health Services in September 2026. The final form of the 2027 changes and their date will be determined by the amendment to the List of Health Services once it is issued.

Keywords:

surveillance – screening – colonoscopy – colorectal cancer – health policy

Sources

1. Bray F, Laversanne M, Sung H et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024; 74 (3): 229–263. doi: 10.3322/caac.21834.

2. Národní screeningové centrum, Ústav zdravotnických informací a statistiky ČR. Program screeningu kolorektálního karcinomu. 2026 [online]. Available from: https: //nsc-data.uzis.cz/ a https: //www.kolorektum.cz.

3. Ambrožová M, Dvořák P, Chloupková R et al. Hodnocení programu screeningu kolorektálního karcinomu v České republice. Gastroent Hepatol 2025; 79 (5): 361–370. doi: 10.48095/ccgh2025361.

4. Věstník Ministerstva zdravotnictví ČR. Program screeningu kolorektálního karcinomu v České republice. 2025; částka 22 : 283–289.

5. Věstník Ministerstva zdravotnictví ČR. Doporučený standard pro poskytování a vykazování výkonů v rámci screeningu kolorektálního karcinomu v České republice. 2024; částka 16 : 48–54.

6. Vuik FE, Nieuwenburg SA, Bardou M et al. Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years. Gut 2019; 68 (10): 1820–1826. doi: 10.1136/gutjnl-2018-317592.

7. Siegel RL, Wagle NS, Cercek A et al. Colorectal cancer statistics, 2023. CA Cancer J Clin 2023; 73 (3): 233–254. doi: 10.3322/caac.21772.

8. Chen FW, Sundaram V, Chew TA et al. Advanced-stage colorectal cancer in persons younger than 50 years not associated with longer duration of symptoms or time to diagnosis. Clin Gastroenterol Hepatol 2017; 15 (5): 728.e3–737.e3. doi: 10.1016/j.cgh.2016.10.038.

9. US Preventive Services Task Force. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA 2021; 325 (19): 1965–1977. doi: 10.1001/jama.2021.6238. Erratum in: JAMA 2021; 326 (8): 773. doi: 10.1001/jama.2021.12404.

10. Voigtländer S, Kajüter H, Wellmann I et al. Incidence trends of early-onset colorectal cancer in Germany: a registry-based study from 2003 to 2023. Int J Cancer 2026; 159 (9): 2207–2218. doi: 10.1002/ijc.70600.

11. Janssens S, Van Herck K, Francart J et al. Evaluating incidence and mortality trends of early-onset colorectal cancer and adenoma in Belgium. ESMO Gastrointest Oncol 2026; 12 : 100340. doi: 10.1016/j.esmogo.2026.100340.

12. Gartlehner G, Schernhammer E, Lax SF et al. Screening for colorectal cancer: a recommendation statement of the Austrian National Committee for Cancer Screening. Wien Klin Wochenschr 2023; 135 (17–18): 447–455. doi: 10.1007/s00508-023-02209-0. Correction in: Wien Klin Wochenschr 2023; 135 (17–18): 456. doi: 10.1007/s00508-023-02251-y.

13. Chiu HM, Chen SL, Su CW et al. Long-term effectiveness associated with fecal immunochemical testing for early-age screening. JAMA Oncol 2025; 11 (8): 846–854. doi: 10.1001/jamaoncol.2025.1433.

14. Rada Evropské unie. Doporučení Rady ze dne 9. prosince 2022 o posílení prevence prostřednictvím včasného odhalování: nový přístup EU ke screeningu nádorových onemocnění (2022/C 473/01). Úřední věstník EU 2022; C 473 (13. 12. 2022): 1–10.

15. Toes-Zoutendijk E, Arbyn M, Auvinen A et al. European Code Against Cancer,5th edition –⁠ organised cancer screening programmes. Mol Oncol 2026; 20 (1): 134–153. doi: 10.1002/18 78-0261.70197.

16. Falt P, Cyrany J, Kunovský L et al. Doporučené postupy České gastroenterologické společnosti ČLS JEP pro diagnostickou a terapeutickou koloskopii –⁠ aktualizované vydání 2024. Gastroent Hepatol 2024; 78 (3): 197–235. doi: 10.48095/ccgh2024197.

17. Hassan C, Antonelli G, Dumonceau JM et al. Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline –⁠ Update 2020. Endoscopy 2020; 52 (8): 687–700. doi: 10.1055/a-1185-3109.

18. van Leerdam ME, Roos VH, van Hooft JE et al. Endoscopic management of Lynch syndrome and of familial risk of colorectal cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2019; 51 (11): 1082–1093. doi: 10.1055/a-1016-4977.