Colorectal screening program implementation in primary health care, in Loures-Odivelas, Portugal

Abstract

Abstract Problem In 2020, Portugal had the highest cumulative incidence of colorectal cancer (CRC) in the European Union (103 new cases/100,000 inhabitants). The Colorectal Cancer Screening Program (CRCS) is based on fecal occult blood testing (FOBT) as the primary screening method. With the delivery of the stool sample collection device; instruction on its use is provided by the Primary Health Care team. The sample is processed at the Clinical Pathology laboratory of the Hospital Center (HC). In case of a positive result, the general practitioner communicates the result and refers the individual to the Follow-up and Treatment Center. Description The general objective of this project was to implement the CRCS in the 19 Family Health Units (FHU) of Loures-Odivelas Health Center Group, between September 2022 and April 2023. The following activities were carried out: 1. Sessions to present the patient pathway, record platform, and stool sample collection device; 2. Application of a checklist of essential points for the start of screening; 3. Preparation and dissemination of monitoring reports to the FHU; 4. Follow-up visits to clarify doubts. Results By March 2023, CRCS had been implemented in 15 of the 19 FHU (79%). Between September 2022 and March 2023, 1,430 devices were delivered and 959 FOBT samples were received (67%). Among the devices received with biological samples, it was not possible to issue a result for 5%. Lessons The activities carried out allowed for the initiation of CRCS in most FHU. The involvement of professionals in these activities contributes to increased patient adherence and proper collection technique, reducing inconclusive FOBT results. It is necessary to continue this strategy of personalized support for the FHU to consolidate the implementation of CRCS in LO HCG. Ensuring that the necessary materials are available and that result issuance and referral deadlines are met are important factors for maintaining professional motivation. Key messages • The objective was to implement the Colorectal Cancer Screening Program (CRCS) in 19 Family Health Units (FHU) in Loures-Odivelas. By March 2023, CRCS had been implemented in 15 of 19 FHU (79%). • It is important to continue these activities in order to put into operation the CRCS in all FHU and to tackle the problem of colorectal cancer.