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

Klinička dijagnoza kolorektalnog karcinoma i metode probiraClinical diagnosis of colorectal cancer and screening procedures

Miroslava Katičić

Borba protiv karcinoma važan je čimbenik u nastojanju za produljenjem životnog vijeka u dobrom zdravlju. Primarnim preventivnim mjerama pokušava se smanjiti ili posve spriječiti utjecaj čimbenika koji izazivaju nastanak ranih neoplastičnih promjena. Većina ovih čimbenika je vrlo ovisna o socioekonomskom stanju populacije, a to ujedno predstavlja i glavni razlog neuspjeha ovih mjera. Sekundarnim preventivnim mjerama pokušava se otkriti neoplastična promjena u vrlo ranom i ograničenom stadiju, u stadiju tzv. premalignih lezija ili ranih karcinoma, kad je liječenje jednostavno, a uspjeh terapije vrlo dobar. Samo se takvom strategijom može smanjiti broj novonastalih karcinoma. U najvećem se broju zemalja za otkrivanje kolorektalnog karcinoma preporučuje kombinacija tri metode: test na skriveno krvarenje u stolici (FOBT), sigmoidoskopija i kolonoskopija 

Ključne riječi:
kolorektalni karcinom, CRC, prevencija, program odabira, FOBT, kolonoskopija

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

The dramatic increase in life expectancy and steady ageing of global population means that there are more opportunities for cancer. In developing countries, the population in frequencies of cancer is expected to at least double during the next 30 years. In developed countries, the perspective varies in relation to tumor sites, but the total figure is also expected to increase. The defense of a longer life and life expectancy in good health includes the institution of programs of prevention against cancer. Primary prevention aims to suppress the environmental causes of cancer, thus inhibiting cancerogenesis. However, the multiple and non specific environmental causes are influenced by uncontrollable socio-economic factors. This is why a priority is usually given by health authorities to secondary prevention programs; detection and treatment at the early stages of the development: either a premalignant lesion or early cancer. Only this strategy may decrease the annual number of new cases of cancers. Early detection in uncomplaining persons is possible only by chance or through mass screening strategy. In the majority of countries, combination of three screening methods is recommended: FOBT, sygmoidoscopy, and colonoscopy. The Croatian National CRC Screening Program recommends: in the first two years the questionnaire and FOBT will be distributed for all people in Republic of Croatia aged between 50 and 75 ys. Colonoscopy will be offered and organised for all FOBT- positive persons, with immediate treatment if needed. For all FOBT-negative people, new FOBT and colonoscopy for positive patients will be repeated every two years. Every polyp found has to be excised, followed by Colonoscopic surveillance every 3-5 years. 

Key words:
colorectal cancer, CRC, prevention, screening program, FOBT, colonoscopy