Epidemiologija i probir kolorektalnog karcinoma

Colorectal cancer (CRC) is global problem with 1.36 million new cases each year. Moreover it is the third most common cancer in men worldwide (746,000; 10%) and second most common in women (614,000 cases; 9.2%). The main characteristic of colorectal cancer is slow development and long presympthomatic phase, so it make possible for early diagnose as well as prevention by removing polyps. Faecal occult blood testing (FOBT) for early detection of colorectal cancer is an evidence based, cost-effective screening strategy and is the most commonly chosen approach in organised population-based colorectal cancer screening programmes throughout the world. There are two main kinds of tests-one guaiac based which detects hem in haemoglobin and other, immunochemical directed to detect protein part globuline. All FOBT positive persons are sent to colonoscopy. CRC incidence and mortality data in Croatia still show high values, especially in males so national colorectal cancer screening programme started in Croatia under the auspices of the Ministry of Health and Welfare (now the Ministry of Health) at the end of 2007. All citizens age 50-74 years are invited to programme. First cycle lasted longer due to legal and financial difficulties related to the harmonization of legislation with EU law and finished in 2012. Response rate was 21%, so the second cycle started in September 2013thin reorganized form which includes educational and promotive campaign and participation of primary care physicians and field nurses.Rak debelog crijeva globalni je problem s 1.36 milijuna novih slučajeva svake godine. Štoviše, u muškaraca je to treće najučestalije sijelo (746,000; 10%) i drugo u žena (614,000 cases; 9.2%). Glavna osobina raka debelog crijeva je spori razvoj bolesti i dugo razdoblje do pojave prvih znakova, što ga čini pogodnim za rano otkrivanje kao i prevenciju uklanjanjem polipa. Testiranje na skrivenu krv u stolici za rano otkrivanje kolorektalnog raka je utemeljeno na dokazima i kost-učinkovita je strategija, pa je najčešći pristup provedbom organiziranih populacijskih programa diljem svijeta. Dvije su glavne vrste testova na skrivenu krv u stolici- gvajakov koji otkriva hem u hemoglobinu i imunokemijski temeljen na reakciji s globulinskim dijelom. Sve osobe s pozitivnim testom upućuju se na kolonoskopjiju. Pojavnost i smrtnost od raka debelog crijeva u Hrvatskoj još uvijek pokazuju visoke vrijednosti, osobito u muškaraca, te je 2007. god. započeo nacionalni program ranog otkrivanja u organizaciji Ministarstva zdravlja. Svi građani u dobi 50-74 godine pozivaju se u program. Prvi ciklus trajao je dulje od planiranog zbog zakonskih i financijskih problema vezanih uz harmonizaciju zakona sa zakonima EU, te je završio 2012. godine. Odaziv je bio 21%, a drugi ciklus počeo je u rujnu 2013. u reorganiziranom obliku što uključuje edukacijsku i promotivnu kampanju te učešće obiteljskih liječnika i patronažnih sestara