Colorectal cancer (CRC) is a major health problem and it is expected that the number of persons diagnosed with CRC and CRC-related deaths will continue to increase. However, recent years have shown reductions in CRC incidence and mortality particularly among individuals aged 50 years and older which can be attributed to screening, improvements in patients’ management, closer adherence to treatment guideline recommendations and a higher utilization of curative surgery, chemotherapy and radiotherapy. The International Agency for Research on Cancer has concluded that there has been sufficient evidence that biennially screening using a stool-test or once-only endoscopy screening reduces CRC-related mortality. In Europe, between 2008 and 2018, nine countries have successfully implemented a population-based organized program and another six are in the roll-out phase. Population-based organized programs show higher screening participation rates and lower lack of compliance to follow-up testing after a positive screen test compared to opportunistic screening. Moreover, organized programs aim to provide high quality screening thereby reducing the risk of the harms of screening, including over-screening, and complications of screening, and poor follow-up of those who test positive. We describe how population-based organized CRC screening programs are preferred, since they reflect a more appropriate utilization of available resources, reduce inequities in access, and can integrate interventions addressing barriers to screening at the individual and health system levels.

结直肠癌（CRC）是一个主要的健康问题，预计诊断为结直肠癌的人数和结直肠癌相关的死亡人数将继续增加。然而，近年来，结直肠癌的发病率和死亡率有所下降，特别是在 50 岁及以上的人群中，这可归因于筛查、患者管理的改善、更严格地遵守治疗指南建议以及治愈性手术、化疗和放疗的更高利用率。国际癌症研究机构得出的结论是，有足够的证据表明，每两年进行一次粪便检测或仅进行一次内窥镜检查可降低结直肠癌相关死亡率。在欧洲，2008 年至 2018 年间，有 9 个国家成功实施了以人口为基础的有组织计划，另外 6 个国家正处于推广阶段。与机会性筛查相比，基于人群的有组织计划显示出更高的筛查参与率，并且在阳性筛查测试后对后续测试的依从性较低。此外，有组织的计划旨在提供高质量的筛查，从而降低筛查危害的风险，包括过度筛查、筛查并发症以及对检测呈阳性者的跟踪不力。我们描述了如何优选以人群为基础的有组织的结直肠癌筛查计划，因为它们反映了对现有资源的更适当利用，减少了获取方面的不平等，并且可以整合干预措施来解决个人和卫生系统层面的筛查障碍。