Factors for effective colorectal cancer screening

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Background: There is a growing emphasis on colorectal cancer (CRC) screening in global world population and also in our country. Althout there is a growing awareness of digestive cancers among the general population in Slovenia, there will remain a large proportion of the population who will not seek screening and will only be screened for CRC if their physician raises the issue or if a population based screening program is established. Despite that the CRC screening is widely recommended. There is often under-utilisation of its guidelines and certain groups are at increased risk of not receiving CRC screening or recommendations for screening in their social community. Social and health policy interventions to reduce these disparities should be an integral part of overall effort to improve CRC prevention and control in general population. CRC is unique in that there are several potential screening modalities availaible with different levels of scientific evidence to support their efficacy. Conclusions: The purpose of CRC screening is to detect early stages of the disease with better prognosis and low mortality. Screening needs to be associated with public information programs and should provide warnings about awareness and poor incorporation of screening guidelines into primary care programs. Screening test needs to be simple, safe and acceptable. The screening tests for CRC include fecal occult blood testing (FOBT), imaging procedures which include sigmoidoscopy, colonoscopy and radiography with barium enema. Insurance coverage and health care programs are often been associated with the level of realisations of screening programs.