The epidemiology of colorectal cancer (CRC) in the Czech Republic is extremely unfavourable. The alarmingly high rates of incidence (78/100,000--in 2004) and mortality (43/100,000--in 2004) have practically remained unchanged in recent years. It is unclear to what extent this reflects a generally unfavourable genetic heritage, environmental factors or the dietary habits of the Czech population. The Czech Society of Gastroenterology launched a population-based CRC screening program in 2000. The FOBT became the standard procedure for a biannual screening examination performed by the general practitioners. A colonoscopy follows in the event of a positive FOBT result. In three screening rounds in 2003, 2004 and 2005, the number of FOBT performed was 207,636, 232,930 and 239,795, respectively, the number of adenomas found was 4623, 2612 and 6272, respectively. The acceptance and detection rates doubled between 2001 and 2005. In 2005 every sixth case of colorectal cancer was found due to screening programme.