CONTRIBUTION OF THE NATIONAL PROGRAM FOR PREVENTION AND EARLY DETECTION OF COLON CANCER IN THE ISTRIAN COUNTY

Rak debelog crijeva jedan je od najčešćih karcinoma i pretežno je jednako zastupljen i kod muškaraca i kod žena i samim time predstavlja ozbiljan zdravstveni problem u zemljama sa zapadnjačkim stilom života. Epidemiološka istraživanja pokazala su da pušenje, prehrana, višak tjelesne težine, fizička neaktivnost i postotak nasljednih čimbenika čine rizik za nastanak raka debelog crijeva. Isto tako pokazalo se da prevencija ima značajnu ulogu u sprječavanju nastanka karcinoma, odnosno da otkrivanje predmalignih lezija ili adenoma u potpunosti isključuje nastanak raka debelog crijeva. Cilj ovog rada bio je prikazati doprinos drugog ciklusa Nacionalnog programa prevencije i ranog otkrivanja raka debelog crijeva u Istarskoj županiji u razdoblju od listopada 2013. do travnja 2016. godine, odrediti stopu uspješnosti provedbe Programa i u konačnici vidjeti rezultate koji su proizišli provedbom Programa. U Istarskoj županiji rak debelog crijeva nalazi se na drugom mjestu kod oba spola u odnosu na ostale karcinome. U drugom ciklusu Programa pozvano je 75.460 osoba oba spola, međutim testiranje je obavilo 12.687 osoba oba spola što je vrlo malen broj odazvanih. Pozitivan nalaz testa na okultno krvarenje utvrđen je kod 715 osoba i sve su pozitivne osobe bile naručene na kolonoskopiju. Kolonoskopiju je obavilo 629 osoba. Pozitivan nalaz kolonoskopije utvrđen je kod 566 osoba. Rak debelog crijeva dijagnosticiran je kod 21 osobe, dok su ostali pozitivni nalazi pripali drugim bolestima debelog crijeva. Postoji razlika u usporedbi Istarske županije s Primorsko-goranskom županijom i Gradom Zagrebom, a očituje se u manjem odazivu osoba iz Istarske županije u odnosu na Grad Zagreb, a veći u odnosu na Primorsko-goransku županiju. U Istarskoj županiji veća je učestalost pozitivnih nalaza stolice na okultno krvarenje, a manja učestalost pojavnosti raka debelog crijeva u odnosu na Primorsko-goransku županiju. Iz priloženih podataka dobivenih istraživanjem daje se zaključiti kako je odaziv na testiranje izrazito slab i u daljnjem radu potrebno je pružanje bolje informiranosti građana kako putem medija, tako putem liječnika obiteljske medicine jer su oni neposredno u kontaktu s osobama koje obuhvaća Program.Colorectal cancer is one of the most common types of carcinoma, and is usuallyequally present with both men and women, thus representing a serious health problem in countries nurturing the western life style. Epidemiological research has shown that smoking, diet, overweight, physical inactivity and the percentage of hereditary factors represent a risk for the occurrence of colorectal cancer. It has also been shown that prevention has an important role in preventing the occurrence of carcinomas, and that detecting premalignant lesions or adenoma completely excludes the possibility for colorectal cancer occurrence. The aim of this paper was to present the contribution of the second cycle of the National Programme of Prevention and Early Detection of Colorectal Cancer in the County of Istria from October 2013 to April 2016, the success rate of the programme conduction, and eventually the results of the conduction of the Programme. In the County of Istria colorectal cancer is at the second place of all other carcinomas with both sexes. In the second cycle of the programme 75,460 persons of both sexes were invited, but examination was undergone by only 12,687 persons of both sexes, which is a really small number of respondents. A positive finding of the occult bleeding test was determined for 725 persons, and all positive persons were called for colonoscopy. Colonoscopy was undergone by 629 persons. For 566 persons, the colonoscopy results were positive. Colorectal cancer was diagnosed to 21 persons, while the other positive results were attributed to other diseases of the colon. There is a difference between the County of Istria, the Primorje - Gorski Kotar County and the City of Zagreb, and it is seen in a smaller number of persons responding in the County of Istria than in the City of Zagreb, but at the same time the number of respondents was larger than in the Primorje - Gorski Kotar County. In the County of Istria, the positive results of the occult bleeding test are more common, but the frequency to which colorectal cancer occurs is lower than in the Primorje - Gorski Kotar County. The obtained results lead to the conclusion that responses for testing are extremely low, and in the future it will be necessary to offer better information to citizens, both through the media, and through family practitioners who are in direct contact with persons included in the Programme