1) build on and expand previously highly successful efforts to improve control of common cancer in the European Union through secondary prevention

2) improve control of colorectal cancer in the general population leading to future decrease in disease-specific incidence and mortality by developing comprehensive, best practice guidelines for quality assurance of population-based colorectal cancer screening which are suitable for implementation throughout the EU member states

3) promote cooperation between member states in guideline development and implementation

4) make available to all member states expertise in high quality colorectal cancer screening

5) facilitate implementation of effective colorectal cancer screening programmes in interested member states through networking

6) tap the available expertise and address the perspectives and needs in colorectal cancer screening of the new member states which entered the Union in 2004

Colorectal cancer is a leading cause of cancer-induced death in the European Union, second only to lung cancer in men and breast cancer in women. Detection of precursor lesions or early stage disease permits effective treatment before the disease is no longer curable. In such cases, the balance between benefit and harm of early detection is quite favourable because detrimental effects of treatment on quality of life can generally be kept to a minimum.
Rollout of population-based colorectal cancer screening programmes in line with the Council Recommendation on implementation of evidence-based screening (COM (2003) 230 final) is imminent in some member states, notably Finland and Great Britain; and other member states are poised to follow. However, scientifically sound best practice guidelines for quality assurance of colorectal cancer screening have yet to be developed.
For ethical reasons and to assure the most effective use of resources, such guidelines should be made available to all member states.
Pan-European cooperation will be a key to successful and timely development of best practice guidelines on quality assurance of colorectal cancer screening for a number of reasons. Firstly, the screening process is complex and many-faceted extending from invitation to take and performance of the screening test and including, in some cases, not only additional diagnostic investigation (assessment) but also treatment of screen-detected lesions. Secondly, when implemented on a population level, the total number of borderline cases requiring special expertise for adequate and appropriate diagnosis and treatment dramatically increases - although such cases are generally rare in a clinical setting. Furthermore, even fewer scientists and clinicians throughout Europe have experience in organized colorectal cancer screening.
Thus, to successfully develop comprehensive best practice guidelines on colorectal cancer screening a pan-European effort will be required. In this endeavour, those European experts with experience in evidence-based colorectal cancer screening will collaborate with experts in the previously established European cancer screening networks in which best practice guidelines in breast and cervical cancer screening have already been developed. Furthermore, the screening experts will be linked with leading clinicians, public health specialists and administrators as well as client and patient representatives in the other member states.
This cooperative approach will permit the special needs and conditions in all of the member states to be taken into account in the development of the standards and recommendations laid down in the guidelines.
Pan-European cooperation will also be essential to rapid and effective dissemination of the project results.
Finally, pan-European cooperation in guideline development will also permit ongoing efforts on testing alternative screening strategies to be taken into account.