Cancer In Lithuania Research Articles

276 (PB-092) Poster - Epidemiology of HER2-low breast cancer in Lithuania

276 (PB-092) Poster - Epidemiology of HER2-low breast cancer in Lithuania

54 - Incidence, mortality and survival trends of penile cancer in Lithuania 1998–2017

54 - Incidence, mortality and survival trends of penile cancer in Lithuania 1998–2017

Incidence, mortality and survival trends of penile cancer in Lithuania 1998-2017.

The aim of this study was to analyse trends in penile cancer incidence, mortality, and relative survival in Lithuania during the period of 1998-2017. The study was based on all cases of penile cancer reported to the Lithuanian Cancer Registry between 1998 and 2017. Age-specific rates standardized rates were calculated, using the direct method (World standard population). The Joinpoint regression model was used to provide estimated average annual percentage change (AAPC). One-year and five-year relative survival estimates were calculated using period analysis. Relative survival was calculated as the ratio of the observed survival of cancer patients and the expected survival of the underlying general population. During the study period, the age-standardized incidence rate of penile cancer varied between 0.72 and 1.64 per 100 000, with AAPC 0.9% (95% CI -0.8-2.7). The mortality rate of penile cancer in Lithuania during this period varied from 0.18 to 0.69 per 100 000, with AAPC of -2.6% (95% CI -5.3-0.3). Relative one-year survival of patients, diagnosed with penile cancer improved over the time from 75.84% in period 1998-2001 to 89.33% in period 2014-2017. Relative five-year survival rate of patients, diagnosed with penile cancer changed from 55.44% in period 1998-2001 to 72.90% in period 2014-2017. The incidence rates of penile cancer showed an increasing trend, while mortality rates were decreasing in Lithuania during 1998-2017. One-year and five-year relative survival increased, however, it does not reach the highest scores of Northern European countries.

Incidence, Mortality, and Survival Trends in Cancer of the Gallbladder and Extrahepatic Bile Ducts in Lithuania.

Background and Objectives: Gallbladder cancer is a rare type of cancer, with aggressive clinical behavior. Limited treatment options provide poor survival prognosis. We aimed to investigate the incidence, mortality trends, and survival of gallbladder and extrahepatic bile duct cancer in Lithuania between 1998 and 2017. Materials and Methods: The study was based on the Lithuanian Cancer Registry database. The study included all cases of cancer of the gallbladder and extrahepatic bile ducts reported to the Registry in the period 1998-2017. Age-specific and age-standardized incidence rates were calculated. In addition, 95% confidence intervals for APC (Annual Percent Change) were calculated. Changes were considered statistically significant if p was <0.05. Relative survival estimates were calculated using period analysis according to the Ederer II method. Results: Age-standardized rates for gallbladder cancer and extrahepatic bile duct cancer among females decreased from 3.91 to 1.93 cases per 100.000 individuals between 1998 and 2017, and from 2.32 to 1.59 cases per 100.000 individuals between 1998 and 2017 among males. The highest incidence rates were found in the 85+ group with 27.5/100,000 individuals in females and 26.8/100,000 individuals in males. The 1-year as well as 5-year relative survival rates of both genders were 34.29% (95% CI 32.12-36.48) and 16.29% (95% CI 14.40-18.27), respectively. Conclusions: Incidence and mortality from gallbladder and extrahepatic bile duct cancer decreased in both sexes in Lithuania. Incidence and mortality rates were higher in females than in males. Relative 1-year and 5-year survival rates showed a steady increase during the study period among males and females.

Retrospective cohort study of androgen deprivation therapy and the risk of diabetes in men with prostate cancer in Lithuania

ObjectivesTo examine the risk of type 2 diabetes in patients with prostate cancer and its association with androgen deprivation therapy (ADT).Design and participantsWe performed a retrospective cohort study of patients...

All-Cause Mortality Risk in National Prostate Cancer Cohort: An Impact of Population-Based Prostate Cancer Screening.

The aim of this study is to evaluate all-cause mortality risk differences before and during prostate cancer screening, with a profound focus on the differences between screened and not-screened patient groups. Prostate cancer cases diagnosed between 1998 and 2016 were identified from the population-based Lithuanian Cancer Registry and linked with screening status in the National Health Insurance Fund database. The analysis was stratified by a period of diagnosis and screening status. Standardized mortality ratios (SMRs) were used to assess all-cause and cause-specific mortality risk. The SMRs were calculated by dividing the observed number of deaths among prostate cancer patients by the expected number of deaths from the general population. All-cause SMR (1.45 (95% CI 1.42–1.48)) in the pre-screening period was higher compared to the screening period (SMR = 1.17 (95% CI 1.15–1.19)). An increased all-cause mortality risk among prostate cancer patients was observed in the not-screened patient population (SMR = 1.76 (95% CI 1.71–1.82)), while all-cause mortality risk in the screened patient population was similar to the general population (SMR = 1.00 (95% CI 0.97–1.02)). Screened patients with localized stage of disease had lower all-cause mortality risk than the general population (SMR = 0.72 (95% CI 0.70–0.75)). In conclusion, men with prostate cancer in Lithuania had excess all-cause mortality risk compared to the general population. The all-cause mortality risk among screened patients was not higher than expected.

Actuarial Analysis of Survival among Breast Cancer Patients in Lithuania.

Breast cancer is the most common cause of mortality due to cancer for women both in Lithuania and worldwide. Chances of survival after diagnosis differ significantly depending on the stage of disease at the time of diagnosis. Extended term periods are required to estimate survival of, e.g., 15–20 years. Moreover, since mortality of the average population changes with time, estimates of survival of cancer patients derived after a long period of observation can become outdated and can be no longer used to estimate survival of patients who were diagnosed later. Therefore, it can be useful to construct analytic functions that describe survival probabilities. Shorter periods of observation can be enough for such construction. We used the data collected by the Lithuanian Cancer Registry for our analysis. We estimated the chances of survival for up to 5 years after patients were diagnosed with breast cancer in Lithuania. Then we found analytic survival functions which best fit the observed data. At the end of this paper, we provided some examples for applications and directions for further research. We used mainly the Kaplan–Meier method for our study.

Trends in Incidence and Mortality of Primary Liver Cancer in Lithuania 1998-2015.

Background: Recently, reports have suggested that rates of liver cancer have increased during the last decades in developed countries; increasing hepatocellular carcinoma and cholangiocarcinoma rates were reported. The aim of this study was to examine time trends in incidence and mortality rates of liver cancer for the period of 1998–2015 in Lithuania by sex, age, and histology. Methods: We examined the incidence of liver cancer from 1998 to 2015 using data from the Lithuanian Cancer Registry. Age-standardized incidence rates were calculated by sex, age, and histology. Trends were analyzed using the Joinpoint Regression Program to estimate the annual percent change. Results: A total of 3086 primary liver cancer cases were diagnosed, and 2923 patients died from liver cancer. The total number of liver cancer cases changed from 132 in 1998 to 239 in 2015. Liver cancer incidence rates changed during the study period from 5.02/100,000 in 1998 to 10.54/100,000 in 2015 in men and from 2.43/100,000 in 1998 to 6.25/100,000 in 2015 in women. Annual percentage changes (APCs) in the age-standardized rates over this period were 4.5% for incidence and 3.6% for mortality. Hepatocellular cancer incidence rates were stable from 1998 to 2005 (APC −5.9, p = 0.1) and later increased by 6.7% per year (p < 0.001). Intrahepatic ductal carcinoma incidence increased by 8.9% per year throughout the study period. The rise in incidence was observed in all age groups; however, in age groups < 50 and between 70 and 79 years, observed changes were not statistically significant. For mortality, the significant point of trend change was detected in 2001, where after stable mortality, rates started to increase by 2.4% per year. Conclusions: Primary liver cancer incidence and mortality increased in both sexes in Lithuania. The rise om incidence was observed in both sexes and main histology groups. The increasing incidence trend may be related to the prevalence of main risk factors (alcohol consumption, hepatitis B and C infections. and diabetes).

Effectiveness of the cervical cancer prevention programme: a case-control mortality audit in Lithuania.

The cervical cancer burden in Lithuania has remained high, and there are no previous effectiveness studies of cervical cancer prevention programme in the country. We investigated the effect of a prevention programme on the risk of mortality from cervical cancer in Lithuania by conducting a mortality audit study. The register-based case-control study included 715 cervical cancer deaths that occurred during 2010-2015 in Lithuania and their 2145 matched controls. Screening histories for cases and controls were obtained from the National Health Insurance Fund database. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression and corrected for self-selection bias. Index screening was associated with a 56% reduction in the cervical cancer death risk, OR: 0.44; 95% CI 0.26-0.74. The ORs for stage I and stage II+ cancers were 0.80; 95% CI 0.32-2.00 and 0.36; 95% CI 0.21-0.62, respectively. The preventive effect was statistically significant for women aged ≥40 years, while nonsignificant for younger. In women who died of cervical cancer, 71% were not invited and 88% were not screened within the recommended 36 months prior to index date. Among cases with index invitation, 32% had index screening compared to 70% in controls. In conclusion, participation in screening has been effective in reducing cervical cancer mortality in Lithuania. The study shows poor screening attendance, emphasizing the importance of greater efforts at the national level to improve the effectiveness of the screening.

Trends in Mortality Rates of Corpus Uteri and Ovarian Cancer in Lithuania, 1987-2016.

Background: The corpus uteri and ovarian cancers burden in Lithuania has remained high. The aim of this study was to investigate time trends in mortality rates of corpus uteri and ovarian cancer in Lithuania across age groups and time periods over a 30-year time span. Materials and Methods: Data on numbers of deaths from corpus uteri cancer during the period 1987–2016 and ovarian cancer during the period 1993–2016 were obtained from the WHO mortality database. Trends in age-standardized mortality rates (ASR, world standard), and age-specific rates were analyzed by calculating annual percentage change using Joinpoint regression. In addition, age–period–cohort analysis was performed for each cancer type. Results: Mortality from corpus uteri cancer decreased by −1.2% (95% CI: −1.8; −0.7) annually from 1987 to 2016. Decrease was most pronounced in youngest age group of 40–49 years; annual percentage change was −2.4 (95% CI: −4.0; −0.9). Mortality rates for ovarian cancers decreased by −1.2% (95% CI: −1.6; −0.8) annually from 1993 to 2016. Corpus uteri and ovarian cancer ASRs in 2016 were 3.5/100,000 and 7.4/100,000, respectively. The age–period–cohort analysis suggests that temporal trends in corpus uteri cancer mortality rates could be attributed to period and cohort effects. Conclusion: A reduction in mortality rate was observed for corpus uteri and ovarian cancer over the entire study period. Similar decreasing pattern for corpus uteri and ovarian cancer mortality indicate effect of shared factors.

A Population-Based Analysis of Incidence, Mortality, and Survival in Testicular Cancer Patients in Lithuania.

Background and objectives: The aim of this study was to analyze trends in testicular cancer incidence, mortality, and survival in Lithuania during the period 1998–2013. Materials and Methods: The study was based on all cases of testicular cancer reported to the Lithuanian Cancer Registry between 1998 and 2013. Age group-specific rates and standardized rates were calculated using the direct method (European standard population). The Joinpoint regression model was used to provide the annual percentage change (APC). Five-year relative survival estimates were calculated using period analysis. Relative survival was calculated as the ratio of the observed survival of cancer patients and the expected survival of the underlying general population. Results: During the study period, the age-standardized incidence rate of testicular cancer increased from 1.97 to 3.45 per 100,000, with APC of 2.97% (95% CI 0.9 to 5.1). Incidence rate of seminomas changed from 0.71 to 1.54 per 100,000, with APC of 2.61% (95% CI −0.4 to 5.7), and the incidence rate of non-seminomas increased from 0.84 to 1.83 per 100,000, with APC of 4.16% (95% CI 1.6 to 6.8). The mortality rate of testicular cancer in Lithuania during this period declined from 0.78 to 0.51 per 100,000, with APC of −2.91% (95% CI −5.5 to −0.3). Relative five-year survival ratio for the period 2009–2013 was 89.39% (95% CI 82.2 to 94.4). In our study, the overall five-year relative survival increased slightly (10.1%) from 2004–2008 to 2009–2013 (from 79.3% to 89.4%). Conclusions: A moderate increase of testicular cancer incidence has been observed in Lithuania between the years 1998 and 2013, while the mortality rate decreased. The five-year relative survival increased according to different period estimates; however, the results could have been higher if a multidisciplinary approach to diagnostics and management in the concerned centers had been implemented in Lithuania as in other countries.

Reduced risk of prostate cancer in a cohort of Lithuanian diabetes mellitus patients.

130 Background: An inverse association has been shown between diabetes and prostate cancer risk. The aim of this study was to determine whether type 2 diabetes mellitus (T2DM) and metformin is associated with prostate cancer risk. Methods: A retrospective cohort design was used to examine the relationship between diabetes and prostate cancer risk. The cohort was composed of male patients identified with diagnosis of T2DM in the National Health Insurance Fund database during 2000–2016. Cancer cases were identified by record linkage with the Lithuanian Cancer Registry which is a nationwide population-based cancer registry that contains personal and demographic information, as well as information on diagnosis of all people diagnosed with cancer in Lithuania since 1978. We calculated standardized incidence ratios (SIRs) for prostate cancers as a ratio of observed number of cancer case in people with diabetes diagnosis to the expected number of cancer cases in the underlying general population. Results: Overall, 68,449 males were diagnosed with diabetes in Lithuania between 2000 and 2016 were included in final cohort. 2,754 prostate cancers were observed versus 3,111.26 expected within a period of observation entailing an SIR of 0.89 (95% CI: 0.85–0.92). Significantly lower risk of prostate cancer was found in diabetic patients in all age groups, there were no differences in prostate cancer risk by time since diabetes diagnosis. Significantly lower risk of prostate cancer also was found in both metformin users and never-users groups, with higher risk reduction in metformin users (SIR 0.71, 95% CI: 0.68–0.75) than in T2DM patients never-users (SIR 0.88, 95% CI: 0.80–0.96). Conclusions: In the large population-based study we found significantly decreased risk of prostate cancer among men with T2DM. Our study suggests that metformin use in patients with T2DM may be associated with reduced risk of developing prostate cancer.

Suicide risk among colorectal cancer patients in Lithuania.

We aimed to estimate suicide risk among colorectal cancer patients in the country showing the highest suicide rates among developed countries. Patients with colorectal cancer diagnosed between 1998 and 2012 were identified from the Lithuanian Cancer Registry. Standardised mortality ratios (SMRs) for suicide were calculated for patients diagnosed with cancer in Lithuania, relative to suicide rates in the general population. Twenty thousand seven hundred sixty-five primary colorectal cancer cases diagnosed between 1998 and 2012 were extracted from the database. Among 19,409 first primary colorectal cancer patients, we identified 67 suicides and the expected number of suicides calculated from general population was 41.4 in this cohort, resulting in an SMR of 1.62 for both sexes (95% CI, 1.27-2.06). A higher suicide risk was found for women (SMR 2.15; 95% CI 1.35-3.41), than for men (SMR 1.48; 95% CI 1.12-1.96). The suicide risk was almost twice higher in patients 60 and older, with highest increase in the oldest patients (SMR 2.12, 95% CI 1.01-4.46). The risk of suicide was not significantly elevated in colorectal cancer patients with localised tumours, but there was a fourfold increase in risk in patients with stage IV tumours. Compared with the general population, the risk of suicide among colorectal cancer patients was four times higher during the first 3months after diagnosis and decreased thereafter. The patients with colorectal cancer have a higher rate of suicide compared with the general Lithuanian population. Sex, age, advanced rectal cancer and distant spread of disease were the main predictors of suicide among colorectal cancer patients.

Lung Cancer Survival in Lithuania: Changes by Histology, Age, and Sex From 2003-2007 to 2008-2012

Lung cancer is the most common cancer-related death worldwide. The aim of this study is to describe the most recent survival rates by sex, age group, extent of disease, and histology of lung cancer in Lithuania. The study is based on the Lithuanian Cancer Registry database. The analysis included patients with primary invasive lung cancer diagnosed in 1998 to 2012 (International Classification of Diseases, Tenth Revision C33 and C34). Patients were followed up with respect to vital status until December 31, 2012. Five-year relative survival estimates were calculated using period analysis. Relative survival was calculated as the ratio of the observed survival of patients with cancer and the expected survival of the underlying general population. In our study, the overall 5-year relative survival was low but increased slightly (10.7%) from 2003–2007 to 2008–2012. Positive changes in survival were evident in both sexes, in almost all age groups and for all histological groups and disease stages. Adenocarcinoma relative survival increased from 6.7% in 2003–2007 to 12.8% in 2008–2012 and squamous cell carcinoma increased from 7.4% in 2003–2007 to 11.1% in 2008–2012. Patients with small-cell carcinoma had the worst survival (2.9% in 2003-2007 and 3.6% in 2008–2012). The majority of patients with lung cancer are diagnosed with advanced disease. The number of new cases of advanced lung cancer increased from 35.1% to 37.8%. Despite low overall survival, there were positive changes in survival in both sexes, in almost all age groups, and for all histological groups and disease stages. The survival rate of patients with lung cancer in Lithuania is similar to that in other European countries.

Socioeconomic status and breast cancer in Lithuania

Introduction In Lithuania, breast cancer (BC) is the most common non-cutaneous cancer and the most common cancer death among women. The aim of this study was to determine the influence of SES on female BC incidence, mortality and survival during the period 2001–2009, using population-based census-linked registry data covering the entire population of Lithuania. Methods The study was based on a census-linked dataset which is based on the linkage of all cancer cases from the Lithuanian Cancer Registry (cancer incidence) and all deaths and emigration records from the Statistics Lithuania for the period 6 April 2001–31 December 2009 to the 2001 population census records at the beginning of the follow-up period (6 April 2001). Emigration records were needed in order to estimate population exposures under risk. The population under study included all of the permanent residents of Lithuania aged 30–74 years on the census day (6 April 2001). Information about urban-rural place of residence and education was taken from census records. Education was classified according to three broad categories of completed education: higher education (at least 14 years of schooling), secondary education (10–13 years of schooling), and lower than secondary education (up to 9 years of schooling). Incidence rate ratios (IRR) and mortality rate ratios (MRR) by education and urban-rural residence were estimated by means of multivariate Poisson regression models controlling for age and using higher education and urban place of residence as reference categories using higher education and urban as a reference category. In order to calculate relative survival rates, life tables for the general population by each educational category and each place of residence were calculated using the same census-linked dataset (cumulative five-year survival rates for the period 2001–2009 were estimated). The expected survival estimates were derived using the Ederer II method. STATA statistical software was used to calculate relative survival and avoidable deaths. Results IRRs showed substantial and statistically significant inverse effects of education and place of residence. The lowest risk of BC was observed in the group of women with lower than secondary education (0.63 times, CI: 0.59–0.67) and in rural areas (0.77 times, CI: 0.73–0.80). Statistically significant lower risk was also observed in the secondary education group (0.80 times, CI: 0.76–0.84), as compared to the higher education. Mortality rates ratios also showed a statistically significant inverse educational mortality gradient. The lowest MRRs were in women with lower than secondary education (0.87 times, CI: 0.79–0.96). There were no significant differences in MRRs by place of residence. We found the same inverse gradient in BC survival, with the worst survival indicators in the lower than secondary education group. Survival rates were significantly decreasing with decreasing education. Five-year relative survival in the higher education group was 80.2%. The absolute difference in survival rates between the highest and the lowest educational groups was 15.3%. The study found a moderate disadvantage in survival among rural women. The same gradient was observed by place of residence too. Conclusions The higher risk of BC in the highest SES in Lithuania corresponds to the results from other countries. For BC, the risk gradient may be explained by other well-established breast cancer risk factors such as postponement of childbearing and low parity which are also more common among females with high SES in Lithuania. Higher SES women are also more likely to obtain routine mammography screening due to better access to preventive healthcare, thereby increasing the detection of breast cancer in this group. SES differences in access to healthcare, modern treatment, as well as inequalities in time of diagnosis may explain the observed differences in BC survival.

Trends in the incidence and mortality of kidney cancer in Lithuania from 1993 to 2012.

Background.The aim of this paper is to analyse trends of kidney cancer incidence and mortality in Lithuania during the period of 1993 to 2012 using joinpoint regression models with special attention to changes in the distribution of stages.Materials and methods.The study was based on all cases of kidney cancer reported to the Lithuanian Cancer Registry between 1993 and 2012. Age group-specific rates and standardized rates were calculated for each sex, using the direct method (world standard population). The joinpoint regression model was used to provide the estimated annual percentage change and to detect points in time where significant changes in the trends occur.Results.During the study period the age-standardized incidence rates increased from 16.89/100,000 in 1993 to 27.77/100,000 in 2012 in males, and from 7.95/100,000 to 13.44/100,000 in females. During this period, annual percentage changes in the age-standardized rates were 2.33% and 1.81% for males and females, respectively. The joinpoint analysis by stage of disease showed the highest increase in stage I kidney cancer, with statistically significant trend change in 2002 for males and in 2001 for females. During the study period, age-standardized mortality rates decreased from 10.42/100,000 in 1993 to 8.96/100,000 in 2012 in males, and from 4.54/100,000 to 3.9/100,000 in females.Conclusions.The kidney cancer incidence rate in Lithuania rose during the period of 1993 to 2012. The detailed analysis by stage showed the most significant increase in organ-confined incidence of kidney cancer. A stable mortality trend for males and a decreasing mortality trend for females along with increased incidence of early stage kidney cancer indicate that both earlier detection and modern treatment modalities may contribute to the reduction of mortality.

17 - Trends in incidence and mortality of kidney cancer in Lithuania in 1993-2012

17 - Trends in incidence and mortality of kidney cancer in Lithuania in 1993-2012

The spectrum of the most common BRCA1/BRCA2 mutations in Lithuanian high risk families

Breast cancer is the neoplasm with the highest incidence and mortality among women in Lithuania. The aim of the study was to determine the mutational incidence in BRCA1 and BRCA2 genes in high-risk breast and/or ovarian cancer families. After written informed consent, 36 participants from Lithuanian health science university hospital provided a blood sample for genetic analysis. Molecular diagnostics was done for 6 BRCA1and BRCA2 mutations. From 36 tested subjects for BRCA1/BRCA2 mutations. Positive test for BRCA1/BRCA2 mutations test was found in 12 (33%) cases. Most common BRCA1 mutation was 5328insC - 6 (50%) cases, other mutations: 185delAG - 1 (8,3%), 300t&gt;6(c61G) - 4 (33,3%), 4153 del A - 1 (8,3%). All mutations were BRCA1, but none of the women were positive for the analyzed BRCA2 mutation. The mean age when the cancer was diagnosed in BRCA1 mutations group was 40.40?3.39 comparing with the group without mutations - 43.29 ?2.52. Rates of BRCA1 and BRCA2 mutation testing are increasing in young women with breast and ovarian cancer. Detected mutations in BRCA1 contribute to up to one-third of the families with breast and ovarian cancer in Lithuania.

Ankstyvų stadijų nesmulkialąstelio plaučio vėžio chirurginio gydymo rezultatai

Didėjant sergamumui plaučių vėžiu Lietuvoje ir pasaulyje išlieka aktualus gydymo efektyvumo gerinimas. Plaučių vėžys dažniausiai diagnozuojamas vyresniame amžiuje. Nesmulkialąstelis plaučių vėžys sudaro apie 85 %, o smulkialąstelis plaučių vėžys – 15 % visų diagnozuotų plaučio vėžio atvejų. Apie 25 % naujai diagnozuotų nesmulkialąstelio plaučio vėžio atvejų būna I–II stadijos, kitais atvejais, deja, nustatomas vietiškai ar atokiai išplitęs plaučių vėžys, kai chirurginis gydymas negalimas. Ankstyvų stadijų nesmulkialąstelio plaučių vėžio gydymas pradedamas nuo radikalios rezekcinės operacijos, jeigu leidžia ligonio būklė. Po operacijos taikoma adjuvantinė chemoterapija platinos preparatais kartu su etopozidu. Nagrinėti 82 IB–IIIA stadijos nesmulkialąsteliu plaučių vėžių sergantys ligoniai, kuriems atlikta radikali rezekcinė operacija ir paskesnė adjuvantinė chemoterapija. Pooperaciniu 1–2 metų laikotarpiu liga progresavo 22 ligoniams (27 %), o 60-iai ligonių (73 %) buvo ligos remisija. Atsižvelgus į šiuos duomenis būtini papildomi DNR tyrimai, kurie leistų individualizuoti gydymą bei pagerinti jo rezultatus.

Familial risk and diagnosis of colorectal cancer in young individuals

The age standardized (world) incidence (per 100000) of large bowel cancer in Lithuania is increasing: in 1993-1997 it was 25.6 for males and 16.8 for females; in 1998-2002 it was 30.4 and 19.1 respectively. Meanwhile the age standardized (world) cancer mortality remains without change: in the same periods it was 18.0 for males and 11.5 for females; 18.6 and 10.6 respectively. These epidemiological aspects are basically for start CRC screening in national population. The age for population screening recommended by EC is 50-74 years and the optimal participation rate to get better survival of CRC patients is 45-60% of population. Numerous studies have shown the risk of getting CRC is higher if a first-degree family member had the disease, and shows that your chances of surviving the disease may be influenced in part by your family ties. It hypothesized that patients with a family history of CRC might be more likely to get screened for the disease, finding tumors earlier, and are more likely to have a better prognosis. In addition to collecting family tree information help for recognition of hereditary cancer syndrome such as HNPCC, Peutz-Jeghers Polyposis, and FAP. The familial risk for CRC and effective cancer prevention become more important in individuals aged below 50-55 years. The study in Lithuania was aimed to prove more knowledge on familial CRC risk and the surveillance of family members at risk for large bowel malignancy. This study indicates that a positive family history of CRC can be recognized as a prognostic factor for individuals aged 25-39 years. Results shows that a positive family history was not a clear indicator of early stage diagnosis in the groups studied compared to the population.