More than half the population over 50 has never been screened for colorectal cancer

Paradoxically, it is mainly people who have the highest risk of developing colorectal cancer that do not get screened for the disease, especially seniors and people with primary or secondary education without a high school diploma. They also include smokers and people who do not engage in any physical activity, said Michala Lustigová of SYRI and the National Cancer Research Institute at a seminar today. Prevention programmes should focus more on these groups in the future.

Screening is also avoided by those who consistently fail to visit a general practitioner and do not even undergo routine blood pressure or blood sugar measurements. “Another interesting finding is the fact that individuals who rate their health as very good do not go for screening. This gives the false impression that seeking health care is only necessary when a person feels unwell,” Lustigová pointed out.

According to the data used by SYRI researchers, up to 56% of people over the age of 50 have never been screened for colorectal cancer in their lifetime. People most often claim that they “have no symptoms”. 54% of respondents chose this answer. Another 18% said they did not know why they have not undergone screening. Other barriers frequently mentioned included fear - either of the examination itself, of possible side effects or of an unfavourable diagnosis. These reasons were mentioned by 14% of respondents. On the other hand, reasons related to access to care proved to be quite marginal. They were mentioned by only 2% of people who had never participated in screening.

The National Screening Programme for Colorectal Cancer, a cancer of the digestive system affecting the colon and rectum, has been running in the Czech Republic for more than 15 years. Nevertheless, participation of the target population, i.e. people in their fifties and older, still falls far short of the European recommendations. “The reason is not the lack of access to care, but rather low health literacy and an inadequate perception of the need for prevention. This is especially true for people who subjectively feel healthy,” Lustigová said. According to data from the Institute of Health Information and Statistics, participation in screening increased only slightly between 2011 and 2023, from 24% to 30%. The data also allows us to track differences by gender, age and region. Statisticians have recorded higher participation among women and people aged 60-74.

The aim of screening is to reduce both the incidence of new cases and mortality from the disease. However, for these programmes to fulfil their purpose, it is essential to achieve high participation among the target population. The optimal participation rate is 65% according to European standards. For most countries, however, the reality is less than half this target.

Better targeted prevention programmes could change this. "It is important to intensify the promotion of health literacy and to provide information about screening in a clear and factual way, adapted to different target groups. We also recommend strengthening the role of general practitioners, who are key players in the field of preventive care and have the potential to effectively motivate their patients," said Lustigová, who also believes that in the future it will be necessary to focus communication activities on people with lower education, who are among the most at-risk groups in terms of low participation in screening.

Colorectal cancer is one of the most severe forms of cancer. In 2022, it was the third most commonly diagnosed malignant neoplasm worldwide and the second most common cause of cancer deaths. Over 1.9 million new cases and more than 900,000 deaths are recorded each year. This disease not only puts a strain on health budgets, but also significantly reduces the quality of life of patients.