EFFICACY OF DECENTRALIZED CRC SCREENING PROGRAM

Aims The aim of this study is to compare the results of a decentralized CRC screening program conducted by the Serbian Ministry of Health in the municipality of Zemun, Belgrade with the results of total colonoscopies performed in the University Clinical Center CHC Bezanijska kosa from January 2014 to December 2018.

Methods This was a retrospective observational study. The data was gathered from Zemun Municipal Health Center and CHC Bezanijska kosa.

Results In 2013, a decentralized CRC screening program was introduced by the Ministry of Health. Patients of ages 50-74 from Zemun Municipal Health Center GP were invited to undergo an FOBT test. Patients who tested positive were advised to undergo colonoscopy. 5727 of 6195 invited patients (92,45%) accepted to be tested.

During the first year, 52,15% of invited patients were tested (434 of 976), but after a dedicated CRC screening unit at Zemun Municipal Health Center was formed, compliance was nearly 100%. FOBT proved positive in 564 (9,85%) patients, all of whom underwent colonoscopy.

Within our endoscopy unit, 285 screening colonoscopies were performed, with the following results:

- 42 patients with carcinoma

- 118 patients with adenomatous polyps, who underwent polypectomy.

Simultaneously, 10,405 colonoscopies were performed independent of the screening program, and 592 carcinomas were found.

The majority of patients were of ages 60-69 and 70-79, with 28 patients under 50.

Conclusions The vast difference in number of patients examined through the screening program compared to the total number of colonoscopies performed at the hospital’s endoscopy unit was attributed to non-adherence to the screening program, with majority of patients avoiding GP and going directly to the hospital.