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In 2024, the screening rate for colorectal cancer in Korea’s national program was 40.3%. That was the lowest of the six cancers in the program, according to the Ministry of Health and Welfare.
So the government wants to change how screening works.
Korea colonoscopy screening is planned to become the first-line test from 2028. It would replace today’s stool-test-first approach.
Here’s what’s changing, what stays the same, and what you can do now.
Korea colonoscopy screening is a plan in the Fifth Comprehensive Cancer Control Plan (2026-2030).
The goal is to offer colonoscopy as the first-line test to adults aged 45-74 from 2028, with a 10-year interval.
Details aren’t final, so today’s system (age 50 and older, stool test first) still applies.
What Is Changing With Korea Colonoscopy Screening?
Korea aims to offer colonoscopy as the first-line test to people aged 45-74 from 2028. The interval would be 10 years.
National cancer screening is a government program that offers regular tests to eligible people so cancers can be found early.
Until now, colorectal screening in Korea has started with a stool test.
Korea colonoscopy screening would flip that order.
On February 24, 2026, the Ministry of Health and Welfare’s National Cancer Control Committee approved the Fifth Comprehensive Cancer Control Plan (2026-2030).
Source: Korea Policy Briefing, February 2026
A public hearing on May 27 presented the Fourth Comprehensive Plan for National Health Screening (2026-2030). It also points toward introducing colonoscopy directly as a first-line test, and it looks at expanding AI-assisted image reading.
Source: Seoul Shinmun, May 27, 2026
| Item | Today | Proposed (target: 2028) |
|---|---|---|
| Eligible age | 50 and older | 45-74 |
| First-line test | Fecal occult blood test (FOBT) | Colonoscopy |
| Interval | Once a year | 10 years |
| When colonoscopy happens | After a positive stool test | Directly, at first screening |
Out-of-pocket costs, how people will be notified, and which clinics will take part haven’t been confirmed in the sources we found.
Korea’s screening guidelines were last revised in 2015 and are due for an update by 2027 (Korea Biomedical Review).
How Is a Stool Test Different From a Colonoscopy?
A stool test looks for tiny traces of blood. A colonoscopy lets a doctor look inside your colon directly.
A fecal occult blood test (FOBT) is a screening test that checks stool for blood you can’t see.
Under today’s rules, people aged 50 and older take it once a year.
If the result is abnormal, a colonoscopy is the second step.
Source: National Health Insurance Service (NHIS, Korea’s public health insurer), colorectal cancer screening guide
- What it checks: The stool test looks for blood. Colonoscopy lets doctors see polyps and cancer directly.
- What a positive means: Bleeding can come from ulcers, hemorrhoids, polyps, stomach cancer, or colorectal cancer. A positive result isn’t a cancer diagnosis.
- Cost: According to the NHIS guide, the NHIS covers the test fee. You pay for sedation if you choose sedated colonoscopy. Rules can change, so confirm at your screening clinic.
The stool test is a first step that looks for signs of blood.
If it’s positive, you need a colonoscopy to find the cause.
Why Is Korea Moving to Colonoscopy at Age 45?
Participation is low, and a pilot study showed colonoscopy screening was feasible and safe.
In 2024, colorectal cancer screening participation was 40.3%. Lung was 52.1%, cervical 60.1%, stomach 63.2%, breast 63.5%, and liver 74.6%.
Source: Korea Policy Briefing, 2026
The Korean Colonoscopy Screening Pilot Study (K-COSPI) enrolled 26,004 people from 2019 to March 2024.
The adenoma detection rate (adenomas are polyps that can become cancer) was 44.3%. Bowel preparation was adequate in 96.0% of people. Perforation occurred in 0.1 per 1,000 procedures.
Source: Journal of Korean Medical Science, 2026
Colorectal cancer was the third most common cancer in Korea in 2023 (National Cancer Center, Korea Central Cancer Registry).
The American Cancer Society (ACS) also recommends that average-risk adults start screening at 45. The sources we found don’t say Korea’s plan is based on that advice.
The same paper says colonoscopy should be phased in where capacity, quality, and safety are in place.
It also suggests keeping the stool test as a default option if participation falls short.
What Should You Do Before the Change?
Follow today’s system for now. If you have symptoms or concerns, see a doctor instead of waiting for a screening slot.
Korea’s national colorectal screening currently covers people aged 50 and older. Ages 45-49 aren’t covered until the new system starts.
✅ If you’re 50 or older, check whether you’re eligible for this year’s national screening
✅ Talk to a doctor if you have blood in your stool, bowel habit changes, or a family history
✅ Watch official announcements for costs and how people will be notified
If your stool test is positive, don’t put off the colonoscopy.
Experts note that follow-up after a positive result needs to be stronger.
You can find more screening guides in Exams and Procedures Guide. (Internal link: replace after related posts are published)
Frequently Asked Questions
1. When will Korea colonoscopy screening start?
The target is 2028. Check later announcements for how it will be run.
2. I’m 45. Can I get a free colonoscopy through the national program now?
Today the program covers people 50 and older, and the first test is a stool test. Ask a doctor about the right timing for you.
3. Does a positive stool test mean I have cancer?
No. Hemorrhoids, ulcers, and polyps can also cause it. A colonoscopy is needed to find the cause.
4. Is colonoscopy safe?
In the pilot study, perforation was rare at 0.1 per 1,000 procedures. Complications can still happen, so talk with your doctor first.
References
- Korea Policy Briefing, “대장암 45세부터 내시경 검진 추진…폐암 국가검진 대상도 확대” (Colonoscopy screening from age 45 planned; lung cancer screening to expand), 2026 Link
- Korea Biomedical Review, “Korea to add colonoscopy to national screening from 2028, expand lung cancer screening,” 2026 Link
- Seoul Shinmun, “영유아 ’14개월 검진 사각’ 메우고, 대장암 검진에 내시경 도입 추진” (Closing the 14-month infant screening gap and introducing colonoscopy to colorectal screening), 2026 Link
- Journal of Korean Medical Science, “From ‘When’ to ‘Ready’: Preparing for Primary Colonoscopy in the Korean National Colorectal Cancer Screening Program,” 2026 Link
- National Health Insurance Service, “대장암 검진” (Colorectal cancer screening), 2022 Link
- National Cancer Center Korea, Korea Central Cancer Registry, “2023년 국가암등록통계 발표” (2023 National Cancer Registry Statistics), 2026 Link
- American Cancer Society, “Colorectal Cancer Guideline | How Often to Have Screening Tests,” 2026 Link
This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Please consult a qualified healthcare provider if you have health concerns.
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