Cancer Screening

Colorectal cancer is the second most common malignant disease among women and the third most common malignant disease among men in Israel, with an average of approximately 2,300 new cases of invasive cancer diagnosed each year in the past 10 years (1). Mortality rates vary according to the stage of the disease at the time of diagnosis (localized, regional, or metastatic), and over the years, a decline in mortality rates has been observed in populations with increased screening rates (2). According to the National Cancer Registry, 39% of patients who were newly diagnosed in 2021 were at early stages of the disease. In addition, the proportion of patients diagnosed with metastatic disease decreased from 19.9% in the year 2000 to 9.5% in 2021 (a reduction of about 45%) (1). These trends likely reflect an increase in the use of screening tests for the early detection of colorectal cancer as part of the national screening program, as well as greater public awareness of the disease. For the general population at average risk, the Israeli Ministry of Health recommends performing a fecal occult blood test once a year from age 50 to 74 (3).

Colonoscopy is an exam used to detect changes or abnormalities in the large intestine and rectum, and also allows the removal of polyps or other types of abnormal tissue when necessary. Identifying and removing benign polyps can help prevent the development of malignant tumors in the future. The test is recommended following an abnormal fecal occult blood test, routinely for individuals at increased risk due to a family history of malignancy, for those reporting gastrointestinal symptoms or bleeding, and for individuals with a prior finding of a lesion in the colon. Professionals recommend performing this test every few years as an early screening method for colorectal cancer, even among individuals at average risk (as an alternative to the fecal occult blood test) (1); however, it is important to note that there is no such official guideline in Israel. After a positive fecal occult blood test, it is important to perform a colonoscopy within a reasonable timeframe (2).