[Evidence-based public health: strategies aimed at increasing adherence to colorectal cancer screening programs]

The ministerial decree 29/11/2001 included colorectal carcinoma screening procedures among the "essential" health care services that should be delivered free of charge to citizens. Secondary prevention programs for colorectal cancer must therefore be implemented in all Italian regions. An international literature search on colorectal cancer screening was performed in order to provide a resource for public health workers and decision makers, for selecting interventions to improve adherence to screening programs. The following interventions have been proven to be effective: reducing structural barriers to screening, active recall systems, multicomponent interventions involving active recall and health education, active reminder systems, periodic dissemination of results, and physician health education. Opportunistic screening by general practitioners, that is, performing faecal occult blood testing in asymptomatic patients consulting a GP for other reasons, is a strategy should also be implemented.