{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:59:43Z","timestamp":1792789183211,"version":"4.5.0"},"reference-count":53,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health of the Czech Republic in cooperation with the Czech Health Research Council","award":["NU22-08-00424"],"award-info":[{"award-number":["NU22-08-00424"]}]},{"name":"Ministry of Defence of the Czech Republic","award":["MO 1012"],"award-info":[{"award-number":["MO 1012"]}],"id":[{"id":"https:\/\/ror.org\/00r7raa16","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Charles University, Prague","id":[{"id":"https:\/\/ror.org\/024d6js02","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/024d6js02","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Colorectal cancer (CRC) incidence and mortality in the Czech Republic ranked among the highest worldwide for decades. The performance of the national screening program over 25 years is reported alongside concurrent population trends. Methods: In this retrospective population-based analysis, registry and health-insurance data on program indicators for 2006\u20132025 were analyzed by calendar year and screening pathway, together with national incidence and mortality for 1977\u20132024. Introduced in 2000 with guaiac fecal occult blood testing, the program added screening colonoscopy in 2009, completed the transition to fecal immunochemical testing (FIT) by 2014, and has used quantitative FIT only since 2020. The target age was 50 and over, redefined as 45\u201374 from 2026. Results: Among 653,825 preventive colonoscopies, at least one adenoma was detected in 251,974 examinations and cancer, including carcinoma in situ, in 16,575. The positive predictive value for adenoma after a positive fecal test rose from 29.6% to 48.3%, and the adenoma detection rate at screening colonoscopy from 25.3% to 32.6%. Cancer detection fell from 6.3% to 2.8% and from 1.8% to 0.5%, respectively. Coverage by screening modalities was 33.7%, and 41.0% including examinations outside the program. Six-month compliance with colonoscopy after a positive FIT was 58.0%. This figure counts colonoscopy under any procedure code and therefore measures whether colonoscopy was performed rather than whether it was reported under the dedicated pathway code. Of all patients with a positive FIT, 37.6% underwent colonoscopy reported under the dedicated FOBT+ colonoscopy code, a subset of the overall 58.0%. Waiting time for FOBT+ colonoscopy was 80 days on average. Age-standardized incidence and mortality were 31.7% and 50.0% lower in 2022\u20132024 than in 1998\u20132000. The declines were not uniform across age: the incidence decline was most pronounced at ages 75 and older, whereas the mortality decline was concentrated at ages 50 to 74. Conclusions: Sustained organized screening coincided with a substantial decline in one of the world\u2019s highest CRC burdens, although its earlier part preceded program expansion. Coverage and completion of FOBT+ colonoscopy remain the principal implementation challenges.<\/jats:p>","DOI":"10.3390\/cancers18193082","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:14:39Z","timestamp":1790151279000},"page":"3082","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Twenty-Five Years of Colorectal Cancer Screening in the Czech Republic: National Registry Trends in Program Performance and Cancer Burden"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3659-0252","authenticated-orcid":false,"given":"Stepan","family":"Suchanek","sequence":"first","affiliation":[{"name":"Department of Medicine, 1st Faculty of Medicine, Charles University, Military University Hospital Prague, U Vojenske Nemocnice 1200, 169 02 Prague, Czech Republic"},{"name":"Department of Gastrointestinal Oncology, Military University Hospital Prague, U Vojenske Nemocnice 1200, 169 02 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3221-310X","authenticated-orcid":false,"given":"Monika","family":"Ambrozova","sequence":"additional","affiliation":[{"name":"Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 601 77 Brno, Czech Republic"},{"name":"National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, 128 00 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2490-8078","authenticated-orcid":false,"given":"Tomas","family":"Grega","sequence":"additional","affiliation":[{"name":"Department of Medicine, 1st Faculty of Medicine, Charles University, Military University Hospital Prague, U Vojenske Nemocnice 1200, 169 02 Prague, Czech Republic"},{"name":"Department of Gastrointestinal Oncology, Military University Hospital Prague, U Vojenske Nemocnice 1200, 169 02 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4091-104X","authenticated-orcid":false,"given":"Renata","family":"Chloupkova","sequence":"additional","affiliation":[{"name":"Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 601 77 Brno, Czech Republic"},{"name":"National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, 128 00 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0034-3084","authenticated-orcid":false,"given":"Ondrej","family":"Majek","sequence":"additional","affiliation":[{"name":"Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 601 77 Brno, Czech Republic"},{"name":"National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, 128 00 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6881-8840","authenticated-orcid":false,"given":"Bohumil","family":"Seifert","sequence":"additional","affiliation":[{"name":"Institute of General Practice, 1st Faculty of Medicine, Charles University, Albertov 7, 128 01 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7509-2734","authenticated-orcid":false,"given":"Petr","family":"Kocna","sequence":"additional","affiliation":[{"name":"Institute of Medical Biochemistry and Laboratory Diagnostics, 1st Faculty of Medicine, Charles University, General Faculty Hospital, U Nemocnice 2, 128 08 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0326-117X","authenticated-orcid":false,"given":"Jan","family":"Bures","sequence":"additional","affiliation":[{"name":"Department of Medicine, 1st Faculty of Medicine, Charles University, Military University Hospital Prague, U Vojenske Nemocnice 1200, 169 02 Prague, Czech Republic"},{"name":"Department of Gastrointestinal Oncology, Military University Hospital Prague, U Vojenske Nemocnice 1200, 169 02 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8589-4378","authenticated-orcid":false,"given":"Ladislav","family":"Dusek","sequence":"additional","affiliation":[{"name":"Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 601 77 Brno, Czech Republic"},{"name":"National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, 128 00 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7883-7431","authenticated-orcid":false,"given":"Miroslav","family":"Zavoral","sequence":"additional","affiliation":[{"name":"Department of Medicine, 1st Faculty of Medicine, Charles University, Military University Hospital Prague, U Vojenske Nemocnice 1200, 169 02 Prague, Czech Republic"},{"name":"Department of Gastrointestinal Oncology, Military University Hospital Prague, U Vojenske Nemocnice 1200, 169 02 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref_1","first-page":"e70090","article-title":"Global cancer statistics 2024: GLOBOCAN estimates of incidence and mortality worldwide for 34 cancers in 186 countries","volume":"76","author":"Sung","year":"2026","journal-title":"CA Cancer J. 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