Abstract

ABSTRACT Introduction Colorectal cancer (CRC) is the third most prevalent human cancer worldwide, with 1 million estimated new cases annually. The National Program of Prevention and Early Detection of Colorectal Cancer started in November 2007. The screening method for early detection of colorectal cancer is the Faecal Occult Blood Test (FOBT). The target population is an asymptomatic population at average risk, aged 50-74. The expected time of one screening cycle was extended from 2 to 4 years because of the technical difficulties in implementing the Program. Invitation letters have been sent by mail. There are three FOBT with instructions for their use, a questionnaire about risk factors and an educational brochure in each envelope. Invited people have been asked to mail applied testing-cards back, together with a filled out questionnaire. People testing positive are invited for colonoscopy in the Clinical Hospital Centre Osijek. Methods The individuals who tested positive for FOBT accepted a colonoscopy examination. During the colonoscopy examination premalignant lesions are removed and the samples are sent for histopathological analysis. Patients are called in to the Clinical Hospital Centre Osijek for a check-up when the gastroenterologist decides on further treatment depending on the results of the analysis. The colonoscopy results are collected and analysed in the Institute of Public health. Results Until February 2012 we sent FOBT to 75.021 individuals (71% of target population). The responding rates are 20.3%. The percent of FOBT positive tests were 9.6%. From 1.412 individuals who were invited 968 underwent a colonoscopy. 87.5% had a pathological finding. There are 68 newly discovered carcinomas (7.0% of those who underwent colonoscopy), 474 polyps (49.0%), 173 haemorrhoids (17.9%), 85 diverticula (8.8%) and 47 other diagnoses (4.9%). 121 individuals were without a pathological finding (12.5%). Conclusion It is necessary to increase public awareness about colorectal cancer. With higher response rates more cancers and premalignant lesions in the population will be detected. The detection of cancer in early stages increases the survival rate and quality of life.

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