Medicinski vjesnik, Vol. 31 No. (1-4), 1999.
Stručni rad
Control of colon cancer: experience with the Osijek program of protection
Zdravko Ebling
Sažetak
It is because of its incidence, that the cancer of the colon ranks second in this country on the scale of disease incidence and mortality caused by malignant diseases. In the period between 1968 and 1994 the incidence per 100 000 inhabitants rose from 13.8 to 37.1 and the rate of mortality increased from 8.3 in 1968 to 28.1 in 1977. Although colorectal carcinoma is fairly easily accessible to diagnosis and therapy, a low 5-year survival rate was recorded in this country (in the City of Osijek only 26.9% of the patients). This research had the following aims: (a) to sum up the previous experience with the application of health-educational activities in the prevention and control of cancer in the Community of Osijek; (b) to report the experience with the validity and specificity of the occult faecal bleeding test (i.e. Hemoccult test) as an indicator of the quality and acceptability for the detection of colorectal carcinoma by way of detecting colorectal carcinoma in Hemoccult negative subjects, as well as to asses the possibilities and limitations of its application in the everyday practice of a family doctor; (c) to show the practical experience with the rehabilitation of patients having colorectal carcinoma. Health-educational activities aimed at the prevention and control of cancer in the Community of Osijek were wellreceived by the population and supported by the health authorities and the general community. In 1998 two booklets were published: "Muškarci i rak" (Men and Cancer) and "Rak prostate" (Prostate Cancer). Each booklet was published in 100 000 copies, and 20 000 copies of the book "Bolesti uzrokovane pušenjem" (Smoking Induced Diseases) were published as well. The observation of colorectal carcinoma in 11 339 Hemoccult negative subjects during an 8-year period (till 1989) revealed colorectal carcinoma in 22 Hemoccult negative subjects: in the first year colorectal carcinoma was detected in 1 Hemoccult negative subject, in the second and third years the respective number of colon cancers was 4, and in the eighth year in 2 Hemoccult negative patients. Test sensitivity was calculated at 92.8% for one-year incidence of colorectal carcinoma and at 72.22% for two-year incidence of colorectal carcinoma. Test specificity was calculated at 99.08%. Research results point to high sensitivity and specificity of the Hemoccult test if it is applied as an early detection method every year or every other year to screen the asymptomatic risk population. The established efficiency of the Hemoccult test points to the need that the detection of colon cancer by means of faecal occult blood testing be carried out at least for the high risk population, and where possible and feasible also for the over-50 age group.This research has shown the need for the application of rectoscopy in family medicine and the need for education of family doctors in the application of this method of colon cancer detection. The experience with the rehabilitation of patients by family doctors shows that it has helped faster inclusion of such patients into family, social life and working environment, and in general to the higher quality of life.
Ključne riječi
Cancer; Colon; Health protection program
Hrčak ID:
191985
URI
Datum izdavanja:
1.12.1999.
Posjeta: 1.030 *