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January 18, 2026Molecular Oncology5 citationsOpen Access

European Code Against Cancer, 5th edition – organised cancer screening programmes

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ETEsther Toes‐ZoutendijkLXLan XuAAAnssi Auvinen

Key Points

  • The aim is to outline sustainable screening programmes for various cancers to improve early detection and outcomes.
  • Recommended biennial quantitative FIT for colorectal cancer in individuals aged 50–74 years.
  • Suggested biennial digital mammography for breast cancer in women aged 50–69, with options for ages 45–49 and 70–74.
  • Proposed HPV screening for cervical cancer every 5 years for women aged 30–65, adapting to vaccination and history.
  • Included annual LDCT for lung cancer screening in high-risk individuals, with an alternative of biennial screening.
  • Colorectal cancer screening can reduce incidence through regular testing using FIT or endoscopy.
  • Breast cancer mortality may decrease with biennial screening via digital mammography in the recommended age groups.
  • Cervical cancer rates could decline with the introduction of HPV screening tailored to vaccination status.
  • Lung cancer screening with LDCT may improve early detection, especially in high-risk smokers.

Abstract

The 5th edition of the European Code Against Cancer (ECAC5) recommends sustainable, organised screening programmes for: (a) colorectal cancer using biennial quantitative faecal immunochemical test (FIT) for individuals aged 50–74 years. As an alternative strategy, once‐only endoscopy may be considered within the same age range; (b) breast cancer using biennial digital mammography for women aged 50–69 years. Implementing this strategy for women aged 45–49 years and 70–74 years can be considered. Other screening strategies or additional examinations could be considered for women with high mammographic density; (c) cervical cancer using human papillomavirus (HPV) screening at intervals no shorter than 5 years for women aged 30–65 years. It is recommended to adapt policies according to vaccination status and screening history; and (d) lung cancer using annual low‐dose computed tomography (LDCT) for individuals considered to be at increased risk of lung cancer based on age, history of smoking or validated risk models, with biennial screening as an alternative. Screening should incorporate smoking cessation interventions.

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Cite This Study

Toes‐Zoutendijk et al. (2026) studied this question.

synapsesocial.com/papers/696c772aeb60fb80d1395616https://doi.org/10.1002/1878-0261.70197
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