Colorectal cancer screening

What is colorectal cancer?

Colorectal cancer is a serious malignant illness. In Denmark, approximately 5,000 men and women are diagnosed with colorectal cancer every year.

Symptoms of colorectal cancer may include:

• blood or mucus in the faeces
• changed bowel habits for a longer period
• stomach pain
• unexplained weight loss.

You should always contact your GP (General Practitioner), if you experience any symptoms from your bowel. This also applies, if you follow the screening programme for colorectal cancer regularly.

Screening for colorectal cancer

The purpose of colorectal cancer screening is to detect colorectal cancer or adenomas (precancerous lesions). Early detection of abnormalities increases the probability of effective treatment.

All men and women aged 50 to 74 years are invited to voluntarily participate in colorectal cancer screening every 2nd year.

The Danish Health Authorities recommend participation in colorectal cancer screening, but it is important that you make your own decision.

Read more about pros and cons of participating in colorectal cancer screening program

Withdraw or reenter the screening programme

It is possible to withdraw temporarily or permanently from the screening programme. If you regret later, it is possible to reenter. 

• Withdraw or reenter from the screening programme (Sundhed.dk- In Danish)

or

• Contact the Department of Public Health Programmes

For those, who have had or have colorectal cancer screening is not relevant.

If you have an illness or condition in the colon or rectum (e.g. Morbus Crohn or Ulcerative Colitis), please contact the surveying department.  They will decide, whether colorectal cancer screening is relevant for you. 

Invitation to screening

You will receive an invitation every 2nd year.

You will receive the first invitation approximately three months after you turn 50, and your last invitation between the age of 73 and 75 years.

You are always welcome to contact Department of Public Health Programmes for information on when to expect an invitation to colorectal cancer screening

Preparation

The invitation is distributed by ordinary mail and contains a self-sampling kit and a guide on how to do the test. 

If you do not want your GP to receive the screening result, you must deselect this option on Sundhed.dk.

There are no precautions regarding medicine or food prior to the faeces sample. However, do not collect the sample during your period.

The screening test

You collect a small sample of faeces and send the sample to a laboratory, where it is analysed for blood.

After screening

Results of the screening examination

The screening result will normally be sent to you and your GP within ten days. If you do not want your general practitioner to receive the results, you can deselect this opstion on sundhed.dk 

There are three possible result:

• A normal screening result
  A normal screening result means, that no blood is found in the faeces sample. If so, you will be invited to colorectal cancer screening again in approximately two years unless you have reached the age of 75.

• An abnormal screening result
  The result is abnormal, if blood is found in the faeces sample. However, an additional examination is needed to confirm or dismiss colorectal cancer. Therefore, you will be called to an additional examination (colonoscopy) within 14 days. 

• Invalid screening result due to technical issues
  Sometimes a faeces sample cannot be analysed due to technical issues. If so, you will receive a new invitation and self-sample kit within 10 to 14 days.

If you do not receive your screening result, we recommend that you contact the Department of Public Health Programmes.

Contact the Department of Public Health Programmes

If the screening examination shows blood you will be called to an additional examination (colonoscopy).

Colonoscopy

A colonoscopy is a visual inspection of the colon, performed with a flexible camera tube inserted through the rectum.

Colonoscopies are carried out at hospitals in Goedstrup, Randers, Viborg or Horsens.

Before the colonoscopy

Before the colonoscopy Examination of the colon requires careful preparation, removing colon content to optimise the safety and quality of the colonoscopy procedure. The bowel cleansing starts 4 days before the colonoscopy by following a restricted diet. The day before and again 4 hours before the colonoscopy, a dose of laxative is taken to optimise the colon cleansing.

Contact the hospital before the colonoscopy if you are disabled, take anticoagulants, have diabetes, require dialysis, have severe lung or hearth disease, Morbus Crohn, Ulcerative Colitis, Foaling's disease, or if you have colorectal cancer.

If you wish to change the time or place of the additional examination, you must contact the department where the examination is to take place - contact information will appear in the invitation.

During the colonoscopy

A colonoscopy lasts between 30 minutes and 1 hour and is performed by either a nurse or a doctor. 
As colonoscopy can be an uncomfortable experience, milder sedation can be offered. It is possible to be accompanied by a friend or a relative. 

After the colonoscopy

After the colonoscopy you may experience discomfort and/or stomach ache for the rest of the day.

Due to possible discomfort and sedatives it is recommended that you have arranged for someone to drive you home, regardless of use of sedation during the procedure.

Result of the colonoscopy

Outcome of a colonoscopy is one of the following:

• Clean colon
  No abnormalities are found. You will receive the next invitation to colorectal cancer screening in 8 years.
• Adenomas
  

  If adenomas are found, they will be removed. Afterwards you may enter a surveillance programme.

• Cancer
  If cancer is detected, you will be offered treatment and further surveillance.
• Re-examination
  If it was not possible to complete the colonoscopy, a new colonoscopy or CT scan may be relevant.
  

For information in other languages (for instance Urdu, Arabic, Turkish) about the Danish cancer screening programmes, see the following links at sst.dk.

Screening for bowel cancer [sst.dk]