Colon Cancer – the possibilities of improving the screening program by collaborating with family doctors

Abstract:

Colon and rectum cancer is the second leading cancer site in men (after bronchial cancer) and women (afterbreast cancer) in developed countries worldwide, including in Europe and in Croatia. In theory, 90% of „future colon cancers“ can be detected before their malignant alteration. It takes between one and 35 years for their transition from benign to malignant – sufficiently allowing for timely detection and removal of premalignant lesions. The early detection of colon cancer program in Croatia is in line with the guidelines of the National Strategy for Prevention and EarlyCancer Detection, which are an integral part of the overall health care strategy. This program has been continuously implemented in Croatia since 2008. Institutes of public healthin all Croatian counties declare that by the time of diagnosis less than 10% of all colon cancers are localized only on the intestine wall. Also, there is currently an extremely high mortality rate due to late detection, with 2,300 deaths in about 6,300 people diagnosed per year. A reason for this disastrous situationis the low observed response to providing stool samples as requested by the National Program (less than 10%) which is executed through the activities of the county institutes of public health. Building upon the success of the program which transitioned the care of patients on oral anticoagulant therapy to family medicine practicioners, and resulted in 5.000 less deaths in this patient group during the first four years, by using our existing resources we have attempted to find a new model of the early colon cancer detection. 

Key words:
colon cancer; colon cancer prevention; family medicine