NATIONAL PROGRAM OF EARLY DETECTION OF CANCER IN CROATIA

Dobro organiziran i vođen program probira raka na populacijskoj razini mora biti znanstveno utemeljen, dugoročno isplativ, izgrađen na primjerima dobre prakse. Pozitivnima nakon probira mora se garantirati adekvatna dijagnostika i liječenje. Cilj rada je prikazati provođenje nacionalnih programa ranog otkrivanja raka dojke i debelog crijeva u Hrvatskoj. U prvom ciklusu probira na rak dojke (od kraja 2006.) pozvano je na mamografiju ukupno 720.981 žena, udio odazvanih je 58,5%, otkriveno je preko 1.500 karcinoma. Za program probira raka debelog crijeva (od kraja 2007.do početka studenog 2010. godine) poslano je ukupno 808.913 testova. Vraćeno ih je samo 19,9%. Pozitivnih testova je 7,7%. Na kolonoskopiji je bilo 77,5% patoloških nalaza:. 388 karcinoma (5,99%), 2.492 polipa (38,46%), ali i 1.641 nalaza hemoroida i 998 divertikula. Zaključeno je da javnozdravstvena djelatnost u nacionalnim programima ranog otkrivanja raka u Hrvatskoj koristi maksimalno sve svoje resurse. Pripremne aktivnosti, organizacija i koordinacija programa, kontakti i suradnja s obiteljskim liječnicima, specijalističkim jedinicama, medijima, regionalnom i lokalnom samoupravom, partnerstvo s nevladinim udrugama, nadziranje i evaluacija te kontrola kvalitete zahtijevaju ogroman napor i mnogo vremena uz neprestanu edukaciju svih onih koji u programu sudjeluju.Introduction: A well organized and conducted program of cancer screening at the population level should be scientifically based, cost-effective at long term, and designed on the good practice examples. Appropriate diagnosis and treatment should be warranted by high rate of target population inclusion, while appropriate diagnosis and treatment should be warranted for those with positive findings. Aim: The aim is to present implementation of the national programs of early detection of breast and colon cancer in Croatia. Results: In the first cycle screening for breast cancer (since the end of 2006), a total of 720,981 women were invited for mammography, of which 58.5% presented for screening, with more than 1500 cases of breast cancer detected. A total of 808,913 tests were distributed for colon cancer screening from the end of 2007 to the beginning of 2010, of which only 19.9% were returned, 7.7% of these positive. Colonoscopy yielded 77.5% of pathologic findings, including 388 (5.99%) carcinomas, 2492 (38.46%) polyps, 1641 hemorrhoids and 998 diverticula. Conclusion: In Croatia, the public health service has made maximal use of all its resources in the national programs of early cancer detection. Great efforts and time, along with continuous education of all those involved in the program, have been invested in preparatory activities, organization and coordination of the program, contacts and collaboration with family physicians, specialist units, mass media, regional and local authorities, partnership with non-governmental societies, monitoring, evaluation and quality control