In the WHO (World Health Organization) European Region, colorectal cancer (CRC) ranks first in the structure of cancer morbidity, with 471.000 new cases per year and the mortality rate amounting to 28.2 per 100.000 population. In Russia, CRC is the most common cancer with almost 60,000 new cases (both genders) and the second most common cause of cancer mortality (n=39,907). The large-scale studies have demonstrated the reduction of the mortality rate due to the adoption and implementation of the population-based screening programs. The most popular and efficacious methods for CRC screening in the populations at the age from 50 to 75 years subject to the moderate risk of developing colorectal cancer include the endoscopic examination of the large intestine (i.e. sigmoidoscopy, colonoscopy) and the laboratory study of the intestinal contents (the so-called faecal occult blood testing (FOBT)). This approach designed to reduce the risk of death from colorectal cancer constituted the starting point of FOBT-based screening activities in several European countries. The long-standing observational data supporting the effectiveness of colonoscopy screening helped to establish endoscopy as the primary screening procedure for colorectal cancer to be applied for CRC screening implementation while other techniques still await moving from the level of pilot projects to that of national programs. The large-scale studies have shown the reduction in CRC morbidity and mortality rates during the last decades in those counties of Europe as well as in the USA and Japan where the CRC screening programs were adopted and implemented on the large-scale. No such nation-wide CRC screening program has been elaborated and realized in the Russian Federation. The poor awareness as regards colorectal cancer among the Russian population accounts for the high rate of its diagnostics at the late stages of the disease (25.6% at stage IV) in comparison with 18.8% at the same stage in the United States despite the fact that FOBT and colonoscopy are readily available at the primary public health care level. The working group of the European Society of Gastrointestinal Endoscopy (ESGE) published in 2012 year the main recommendations concerning the quality of screening colonoscopy. It requires to take into consideration in the mandatory manner the quality of bowel cleansing and proposes a standard according to which at least 90% of the screening examinations should be rated as giving evidence of «adequate» or better cleansing as well as the minimum standard of 90% for the unadjusted cecal intubation rate. Moreover, ESGE recommends to take account of the number of adenomas and malignant tumours documented in the course of all screening studies. Because the number of lesions thus identified depends on the peculiarities of individual screening programs, the target values should be coordinated with those established by the Screening Committee. ESGE recommends to record the mean colonoscope withdrawal time and proposes 6 minutes as the minimum duration for at least 90% of the diagnostic studies. The number of resected and removed polyps should be documented for all screening colonoscopies on the assumption that a minimum of 90% of all resected polyps should be extracted and used for the histological study. It is concluded that screening colonoscopy should be viewed as a priority health care tool contributing to the reduction of the social burden of cancer and the decrease of all types of health care costs including those for radical surgery, long-term hospitalization and chemotherapy.