engleski

Two years of colorectal cancer screening program in Croatia

INTRODUCTION/OBJECTIVES: Colorectal cancer (CRC) is a major public health burden among malignant diseases worldwide. In Croatia it is the fifth cause of cancer mortality in men (N = 982), and second in women (N = 756) in 2007. The standardized death rate is 46.0/100000 for men, and 32.9/100000 in women. There is clear evidence that screening can reduce CRC mortality and improve outcomes. In almost all of the developed EU countries screening programs are organized. AIMS & METHODS: Croatian National program for CRC screening was established by Ministry of Health and Social Welfare and has been implemented since the September, 2007. The network of coordinators in each county institute of public health are obliged to ensure performing of fecal occult blood testing (FOBT), followed by colonoscopy in all positive cases. The FOBT is performed by guaiac-based Hemognost card test with detection limit of 0.2 ml blood in 500 g of stool. Test and short questionnaire are delivered to home address of all citizens age 50−74 consecutively during two years. Each participant has to fulfill the questionnaire, and send it together with test specimen back to the institute for further analysis. According screening results of other authors, it was expected that 4% FOBT positive cases would be found in normal risk population and model calculations pointed out a need for 24000 colonoscopies per year RESULTS: Of the 617924 individuals (born between 1933 and 1945) screened until now with FOBT, only 130300 (21.1%) returned test specimen. Among them, 11817 (10.9%) were found to be positive. Till now, colonoscopy was ordered for 6203 and already performed in 4525 cases (compliance 73.0%). Screening has identified: 302 CRC (6.7% of patients underwent colonoscopy, 2.6% of all FOBT-positive patients and 0.05% of all screened individuals) ; 1768 polips and 703 diverticula (39.1% and 15.5% respectiveli, of patients underwent colonoscopy). Only 1064 (23.5%) individuals had normal colonoscopy finding. CONCLUSION: Characteristics of Croatian CRC National program in first two-andhalf years were: low percentage of returned FOBT, and very high number of pathologic findings (polyps and cancers). These preliminary results suggest a need of further strengthening of Croatian National program for CRC screening. Disclosure of Interest: None Declared

Colorectal cancer; screening; Croatia

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