[Prevention and early detection of colorectal cancer]

Colorectal cancer (CRC) is still one of the most frequent malignant diseases in Europe and Germany. At the same time, prevention and early detection are particularly effective. This is due to the mostly slow development over precancerous stages and in the possibility of endoscopic removal of these lesions. Modern prevention includes lifestyle counselling, structured invitation procedure, quality-assured colonoscopy, immunological stool tests and an individual risk-adapted follow-up. This article summarizes the current evidence and guideline recommendations in a practical way. The focus is on the counselling of asymptomatic persons with an average risk, the identification of groups at risk, the avoidance of overtreatment and undertreatment as well as improvement of the participation rate for screening and early detection measures. In addition, two particularly clinically relevant problem areas are described, the increase in CRC diagnoses in persons under 50 years of age and the consistent gene-dependent preventive measures in Lynch syndrome.