Colorectal cancer (CRC) is common and is associated with a considerable mortality. Morbidity and thereby mortality can be reduced by using different prevention strategies such as lifestyle interventions and chemoprevention. Endoscopic surveillance of high-risk individuals and population-based endoscopic screening of average-risk individuals enables detection and removal of premalignant lesions (adenomas) as well as presymptomatic detection of cancer. Implementation of cancer detection tests such as fecal occult blood tests (FOBTs) is another strategy to reduce cancer mortality by early detection of CRC. Personalized management, based on estimates of the individual risk using information concerning environmental factors, lifestyle, family history, personality, social background and phenotype in combination with a variety of biomarkers such as genotype, will become more important as a strategy to optimize CRC prevention in the future.