[National colorectal carcinoma screening program deserves further study; a report from the Dutch Health Council]

Each year there are about 8400 new colorectal carcinoma (CRC) cases in the Netherlands. Despite improved treatment possibilities the mortality rate has not shown a decline. A reduction in the mortality rate can be achieved by screening for CRC by means of faecal occult-blood testing. Endoscopic screening (flexible sigmoidoscopy or colonoscopy) could reduce not only the mortality but also the incidence of CRC, but this has yet to be conclusively demonstrated. The introduction of a national screening programme deserves serious consideration, although various questions need to be answered before a final decision can be taken. These concern the optimal screening strategy, the expected degree of participation, the follow-up under persons in whom polyps are found, the demand on human resources and other resources, and the cost-effectiveness.