Introduction – Despite its universal principle, the National Organized Colorectal Cancer Screening Program (PNDOCCR) may not ensure true equity of access in the Île-de-France region. This study aims to provide a regional overview for the period 2015–2024 by describing trends in performance indicators (I_performance) and exploring regional disparities.Methods – This retrospective and analytical study describes and compares trends (2015–2024) in performance indicators (medical exclusion rate — Tx-exclusion; participation rate; proportion of colonoscopies performed within ≤31 days — Tx_colo_mois; Colonoscopy detection rate — Tx_détection) in conjunction with two screening provision ratios (prescribing general practitioner, gastroenterologist) and the social deprivation index in Île-de-France. A segmented regression and a correlation matrix were interpreted.Results – Between 2015 and 2024, the Tx_colo_mois (from 16.4% to 10.7%) and the Tx_détection (from 64.4% to 42.7%) decreased significantly (p<0.05). Significant interdepartmental disparities exist (exclusion rate in 2015: 7.3% in Hauts-de-Seine, 13.0% in Seine-et-Marne; in 2024: 4.1% in Seine-Saint-Denis, 11.3% in Essonne). In 2021, Val-de-Marne had reached a monthly exclusion rate of 32.2%, while the other departments had monthly exclusion rates of less than 20%. Each indicator had ≥1 significant breakpoint (p<0.05) and episodes of sharp post-break decline, coinciding temporally with major organizational events (interruption in the supply of test kits, the COVID-19 crisis, etc.).Conclusion – The program provides broad coverage of the Île-de-France region, with persistent spatial inequalities and temporal disruptions potentially linked to organizational events. To improve equity, universal measures must be combined with targeted interventions (strengthening the backlog of unanalyzed tests, expanding local supply, and regional coordination), and their effects must be monitored.