To evaluate participation rates, test positivity, and colonoscopy outcomes following the extension of a biennial fecal immunochemical test (FIT) colorectal cancer (CRC) screening program to adults aged 70–75. This study assesses the impact of including previously unscreened older adults in a tertiary care health area.

A retrospective analysis of screening data was performed from January 2024 to June 2025 using the official regional CRC screening registry. Invitations were sent to adults aged 50–75 years. Participation, FIT results, colonoscopy completion, and findings were recorded. Data were analyzed descriptively, with positivity rates and detection rates of adenomas and CRC reported. First-time participants aged 70–75 were analyzed separately.

Overall, 79,872 invitations were sent to adults aged 50–75, with 30,854 completing FIT (38.6% participation). FIT positivity was 4.6% (1,426), leading to 1,059 colonoscopies. Adenomas were detected in 49% (524) and CRC in 5.8% (45).

Among newly invited participants (n=9,622), 2,960 completed FIT, with 135 positives (4.5%) and 105 colonoscopies performed. Adenomas were found in 46% (48) and CRC in 1.9% (2).

In the 70–75 age group (n=16,850), participation was 49.5% (8,347). FIT positivity was 5.8% (492), with 423 colonoscopies performed, detecting adenomas in 52% (223) and CRC in 4% (17).

For first-time screened individuals aged 70–75 (n=638), participation was 36% (236). FIT positivity was 9.7% (23), with 18 colonoscopies performed. Adenomas were identified in 44% (8) and CRC in 11% (2).

Extending CRC screening to adults aged 70–75 effectively identifies clinically relevant pathology and engages patients who had not previously participated. While participation remains moderate, inclusion of this age group contributes to early detection and may improve overall program effectiveness. These results support continued evaluation of age expansion in CRC screening programs and highlight the utility of FIT-guided colonoscopy in older populations.