Colorectal cancer is one of the most common and deadly forms of cancer. The latest estimates of the cancer burden in France indicate that in 2018, this cancer affected approximately 43,000 people (23,000 men and 20,000 women) and caused 17,000 deaths (9,000 men and 8,000 women).

Insufficient screening…

Colorectal screening using fecal occult blood testing saves lives by detecting precancerous polyps and early-stage cancers. However, participation in the screening program remains very low. The latest data for the 2017–2018 period show that only 32.1% of men and women aged 50 to 74—the target population for this screening—participate. The participation rate was 33.5% for the 2016–2017 period and around 31–32% for previous periods. These figures are well below the acceptable European benchmark of 45%. The increase in participation in the colorectal cancer screening program that was expected with the change in testing methods in 2015—from the guaiac test to the more sensitive and easier-to-administer immunological test—has therefore not materialized to date. (See participation indicators by sex, age, and region).

…Despite an effective screening test

The screening test was positive in 4% of those screened in 2017–2018. A colonoscopy must be prescribed for these individuals to determine the source of the bleeding. In about 3 out of 10 cases, the colonoscopy will reveal a precancerous polyp, and in 1 out of 10 cases, cancer. Performance data for the immunological test in 2015 show that the immunological test detects 3.7 times more precancerous polyps and 2.4 times fewer cancers than the guaiac test used prior to 2015.

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National estimates of cancer incidence and mortality in mainland France between 1990 and 2018. Study based on cancer registries from the Francim network. Preliminary results. Report and summary.