Introduction In France, screening using a fecal occult blood test is recommended every two years for people aged 50 to 74. If the test is positive, a colonoscopy is offered. An organized screening pilot program has been in place since 2002, and in 2009, the organized program will be expanded to cover the entire country. The overall results and lesions detected in the pilot program are presented. Materials and Methods The aggregated data presented are derived from departmental management structures responsible for inviting the population, collecting follow-up information, and transmitting data to the national level. The full campaign spans two years. As of November 1, 2007, 22 pilot departments had completed their first invitation campaign. At the time of data analysis, the second campaign had been completed in 11 departments. Results The participation rate was 42% in the first campaign. The percentage of positive Hemoccult® tests was 2.6% (first campaign), 2.9% when, in the second campaign, individuals took the test for the first time, and 2.7% for the second time. The program showed that 12 months after a positive test, not all colonoscopy results were retrieved by the administrative systems. This missing information pertains to 13% of individuals with a positive test and includes cases where patients refused colonoscopy, were lost to follow-up at 12 months, or underwent colonoscopy but the results were not reported. Among the 36,000 colonoscopies performed, the number of colonoscopy complications is not available. In the first screening round, cancer was detected in 3,289 people and at least one adenoma in 10,884 people. The detection rate for adenomas was 7.8%, for adenomas larger than 1 cm it was 3.8%, and the cancer detection rate was 2.2%. Among the 2,504 invasive cancers diagnosed, 51% were stage I and II cancers. Conclusion The results are in line with the benchmark for the majority of indicators. Areas for improvement include the participation rate and the rate of colonoscopies following a positive test. Reporting on the follow-up to positive tests is also an area for improvement, in which gastroenterologists play a key role. This concerns not only the performance of the colonoscopy itself and its results but also any potential complications arising from it. Once the program is fully implemented, 15 million people in France will be invited to participate every two years, and approximately 350,000 colonoscopies will be performed. (R.A.)