The Danish national colorectal cancer (CRC) screening program was initiated in 2014. Citizens aged 50-74 years were invited to submit a faecal immunochemical test (FIT) and FIT positive individuals (100 ng/ml hemoglobin per ml buffer – equivalent to 20 µg/g feces) scheduled for colonoscopy within two weeks. Based on the adenoma findings, individuals are risk stratified, and their appropriate recall procedure and interval is determined (1). If no adenomas are detected, an 8-year repeated FIT is scheduled while in case of low-risk adenoma findings (less than 3 tubular adenomas, all smaller than 10 mm and all low-grade neoplasia), a repeated FIT is scheduled after two years instead (1). Despite the described planned recall procedure, the first screening round was rolled out over four years, with all screening eligible individuals invited in that time span, and no re-invitations made in that period. This was done to accommodate the increasing colonoscopy resource demand. The prolonged interval renders a unique opportunity to investigate the interval cancer rates beyond the planned biennial recall. The impact of this large difference in FIT recall intervals between individuals with low-risk adenomas (two years) and individuals with no adenomas (eight years) on post colonoscopy colorectal cancer (PCCRC) occurrence was the focus of this study.
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