[Epidemiology and screening of colon cancer]

Colon cancer is a major health problem in industrialized countries. It ranks at the first place among digestive cancers, with a sex ratio of 1. Colon cancer incidence increased between 1975 and 2005. France belongs to high risk countries for colorectal cancers. Since eighties, there was a progressive switch from left to right colon cancers. Owing to its frequency, and its epidemiological characteristics, colorectal cancer is, in France, justifiable of a national population-based mass screening. In France, national screening relies on biennial testing in subjects between 50 and 74 followed by total colonoscopy in case of positive test. In order to decrease significantly colorectal cancer mortality participation rate has to be over 50%. The colorectal cancer mortality decrease in this case varies between 15 and 28% in the general population, and between 33 and 39% among participants to screening. On the basis of available data, the European Commission recommended organizing colorectal cancer screening in the EU. Colonoscopy screening is recommended for subjects at high risk, or very high risk for colorectal cancer.