MEDIX, God. 14 Br. 75/76  •  Pregledni članak  •  Gastroenterologija HR ENG

Epidemiologija kolorektalnog karcinomaEpidemiology of colorectal cancer

Milan Kujundžić, Marko Banić, Tomislav Bokun

Kolorektalni karcinom (CRC) jedan je od najznačajnijih uzroka pobola i smrtnosti u skupini svih karcinoma: godišnje se u svijetu dijagnosticira oko milijun novih slučajeva. Među svim karcinomima, CRC je u svijetu na četvrtome mjestu po broju novo-dijagnosticiranih slučajeva, a u Hrvatskoj na drugom. Razlika u incidenciji CRC-a između pojedinih populacija može se pripisati okolišnim čimbenicima, za koje se vjeruje da su odgovorni za 70-80% slučajeva bolesti. Najčvršća je veza između loših prehrambenih navika i nedostatne fizičke aktivnosti s jedne i incidencije CRC-a s druge strane. Za kalcij i neke nesteroidne protuupalne lijekove (NSAIDs) literatura bilježi povoljan učinak, no dostupni znanstveni dokazi nisu dostatni za preporuku redovitog korištenja u prevenciji. Na globalnoj je razini prepoznat problem, osnovane su inicijativne skupine i pokrenuti programi s ciljem smanjenja pobola i smrtnosti od CRC-a. 

Ključne riječi:
kolorektalni karcinom, incidencija, rizični čimbenici, pobol, smrtnost

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 14 Br. 75/76

Colorectal cancer (CRC) is a very common cause of cancer morbidity and mortality around the world, with about a million patients diagnosed each year. It is ranked fourth globally whereas in Croatia it ranks second for both genders, after breast cancer in females and lung cancer in males. CRC is slightly more predominant in males than in females. The highest incidence of the disease is found to be in developed countries such as the USA, Australia, New Zealand, Western European countries and the UK. Research on this topic shows, the difference in incidence of the disease is mostly due to environmental factors, which may be responsible for about 70-80% of CRC cases. The strongest correlation is found for bad dietary and nutritional practices as well as physical inactivity. High dietary fat and plenty of meat in the diet increases the probability for developing of CRC. On the other hand, regular intake of fruits, vegetables and fibers in the diet is found to be protective, with a lower incidence of CRC in such population. Scientists have strived to find a medication that could prevent CRC but with little success. Many substances have been proposed to be a cancer preventive but only calcium and some of the NSAIDs showed some positive effect. However, currently available evidence is not strong enough or sufficient for either dietary calcium or NSAIDs to be recommended for CRC prevention. Colorectal cancer is a worldwide problem which has been acknowledged through many initiatives such as IDCA and The Declaration of Brussels by the European Commission. Many different screening programs which are expected to lower CRC related morbidity and mortality substantially, are launched nationally and globally. Still, primary prevention such a change in dietary and nutritional practices and an increase in physical activity remains the effective way to prevent a substantial number of new CRC cases. 

Key words:
colorectal cancer, incidence, risk factors, morbidity, mortality