Medicina Fluminensis, Vol. 62 No. 3, 2026.
Review article
https://doi.org/10.21860/medflum2026_349228
Implementation of the National Breast Cancer Screening Program in Primorje-Gorski Kotar County: Challenges, Achievements, and Perspectives
Ines Vrljić
; Nastavni zavod za javno zdravstvo Primorsko-goranske županije, Odjel za javno zdravstvo, Rijeka, Hrvatska
Iva Sorta-Bilajac Turina
; Nastavni zavod za javno zdravstvo Primorsko-goranske županije, Odjel za javno zdravstvo, Rijeka, Hrvatska
*
Aleksandar Džakula
; Medicinski fakultet Sveučilišta u Zagrebu, Škola narodnog zdravlja „Andrija Štampar“, Zagreb, Hrvatska
* Corresponding author.
Abstract
Breast cancer is a leading public health challenge among women, characterized by high incidence and significant mortality at both European and global levels. Early detection through organized screening programs has been proven to reduce mortality and enable more effective treatment. In the Republic of Croatia, the National Breast Cancer Early Detection Program has been implemented since 2006, aiming to reduce mortality rates and increase the proportion of early-stage diagnoses. Primorje-Gorski Kotar County (PGKC) was a pioneer in this field, introducing screening through a pilot project in 2004. This review aims to present the program’s evolution from a county pilot to a national model, analyse response rates, and identify key challenges and perspectives for improvement, with a focus on PGKC. During eight implementation cycles in PGKC, an average response rate of 56.6% was recorded, rising to 67.9% in the latest cycle. This progress is attributed to a personalized approach involving family physicians and community nursing services in identifying and motivating non-responders. Despite these achievements, the program faces challenges such as geographical barriers, outdated administrative data, logistical difficulties, and the presence of parallel opportunistic screening. The introduction of mobile mammography and the strengthening cross-sectoral cooperation are vital steps in reducing inequalities in healthcare accessibility. In conclusion, the results indicate that further increasing in response rates are achievable through continuous organizational improvements, digitalization, and an individualized approach. These efforts contribute to reducing breast cancer mortality and advancing public health. Systematic efforts in PGKC serve as a vital model for future national strategies, ensuring that early detection remains a priority for all women, regardless of their location or socio-economic status.
Keywords
breast neoplasms; diagnostic screening programs; mammography; women's health services
Hrčak ID:
349228
URI
Publication date:
1.9.2026.
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