Nacionalni program ranog otkrivanja raka dojke

Nacionalni program ranog otkrivanja raka dojke u Hrvatskoj usvojen je na sjednici Vlade Republike Hrvatske 29. lipnja 2006. godine, a u skladu je s odrednicama Nacionalne strategije prevencije i ranog otkrivanja raka, koje su sastavni dio cjelokupne strategije razvoja zdravstva 2006.–2011. godine. Program je sukladan Rezoluciji o prevenciji i kontroli karcinoma (WHA 58.22 «Cancer prevention and control»), koju je usvojila Svjetska zdravstvena skupština 2005. godine

Croatian success in early breast cancer detection: favorable news in Breast Cancer Awareness Month

Breast cancer is the third most common malignant cause of death in women in Croatia, preceded by lung and colorectal cancer. According to the last available data, in 2017 breast cancer was diagnosed in 2767 patients (rate 132.1/100,000), and in 2019, 752 women died from the disease (rate 35.9/100,000). However, the number of deaths has been steadily decreasing for four years in a row (2,3). If we compare the Croatian estimates with those from the European Union (EU-27) countries, we can see that Croatia is near the EU-27 average according to cancer burden (15th out of 27 countries; 14th in men and 19th in women) and fifth according to cancer mortality. However, when we look only at breast cancer estimates, the situation is much better; standardized breast cancer mortality rates for Croatia are below the EU-27 average (16th out of 27 countries) (1). Although the majority of breast cancer cases are not preventable, it is crucial to make the diagnosis at an early stage, when more than 90% of women can be cured. Mammography screening remains the best and widely validated method of early detection of breast cancer, despite its shortcomings and the emergence of other imaging modalities with high diagnostic accuracy

Utjecaj demografskih promjena stanovništva Hrvatske na nacionalne preventivne programe ranog otkrivanja raka

Analizirani su demografskih trendova u tri kontingenta stanovništva koji su ciljne skupine za pojedine programe probira i posredno procijenjen mogući utjecaj na provedbu nacionalnih programa ranog otkrivanja raka u razdoblju do 2030. godine. Procjene demografskih promjena do 2020. godine pokazuju da one neće imati značajniji utjecaj na programe ranog otkrivanja raka dojke te raka debelog i završnog crijeva. U oba programa može se očekivati blagi porast broja osoba ciljnih skupina do 2020. godine, a iza toga do 2030. godine može se očekivati pad osoba ciljnih skupina za spomenuta dva programa. Kod programa ranog otkrivanja raka vrata maternice već sad se bilježi značajan pad pripadnica ciljne skupine, a predviđanja pokazuju da će se trend pada nastaviti do 2030. godine. Prema prikazanim trendovima potrebe za resursima za provedbu nacionalnog programa ranog otkrivanja raka dojke i debelog crijeva neće se značajnije mijenjati do 2030. godine. Trenutno postojeći kadrovi i oprema za kolonoskopiju već sada nisu dostatni u slučaju željenog povećanja odaziva na testiranje stolice na okultnu krv u stolici. Za potrebe provedbe programa ranog otkrivanja raka vrata maternice resursi su ionako nedostatni te se njihov deficit može premostiti uvođenjem HPV testiranja

Utjecaj demografskih promjena stanovništva Hrvatske na nacionalne preventivne programe ranog otkrivanja raka

Analizirani su demografskih trendova u tri kontingenta stanovništva koji su ciljne skupine za pojedine programe probira i posredno procijenjen mogući utjecaj na provedbu nacionalnih programa ranog otkrivanja raka u razdoblju do 2030. godine. Procjene demografskih promjena do 2020. godine pokazuju da one neće imati značajniji utjecaj na programe ranog otkrivanja raka dojke te raka debelog i završnog crijeva. U oba programa može se očekivati blagi porast broja osoba ciljnih skupina do 2020. godine, a iza toga do 2030. godine može se očekivati pad osoba ciljnih skupina za spomenuta dva programa. Kod programa ranog otkrivanja raka vrata maternice već sad se bilježi značajan pad pripadnica ciljne skupine, a predviđanja pokazuju da će se trend pada nastaviti do 2030. godine. Prema prikazanim trendovima potrebe za resursima za provedbu nacionalnog programa ranog otkrivanja raka dojke i debelog crijeva neće se značajnije mijenjati do 2030. godine. Trenutno postojeći kadrovi i oprema za kolonoskopiju već sada nisu dostatni u slučaju željenog povećanja odaziva na testiranje stolice na okultnu krv u stolici. Za potrebe provedbe programa ranog otkrivanja raka vrata maternice resursi su ionako nedostatni te se njihov deficit može premostiti uvođenjem HPV testiranja

Pregled europskih istraživanja o razlozima neodaziva ciljne populacije u preventivnim programima ranog otkrivanja raka

Nacionalni preventivni programi probira za karcinome imaju dugu povijest u europskim zemljama. Trenutno su u većini zemalja aktualna tri programa, programi probira za rak dojke, rak vrata maternice, i rak debelog crijeva. Jedan od nužnih preduvjeta uspješnosti programa ranog otkrivanja karcinoma je postignut zadovoljavajući odaziv ciljne populacije. Ukoliko je odaziv manji od preporučenog, program ne može biti isplativ niti učinkovit u smislu smanjenja incidencije i mortaliteta od malignih bolesti, zbog čega su nužna istraživanja razloga nedovoljnog odaziva

Pregled europskih istraživanja o razlozima neodaziva ciljne populacije u preventivnim programima ranog otkrivanja raka

Nacionalni preventivni programi probira za karcinome imaju dugu povijest u europskim zemljama. Trenutno su u većini zemalja aktualna tri programa, programi probira za rak dojke, rak vrata maternice, i rak debelog crijeva. Jedan od nužnih preduvjeta uspješnosti programa ranog otkrivanja karcinoma je postignut zadovoljavajući odaziv ciljne populacije. Ukoliko je odaziv manji od preporučenog, program ne može biti isplativ niti učinkovit u smislu smanjenja incidencije i mortaliteta od malignih bolesti, zbog čega su nužna istraživanja razloga nedovoljnog odaziva

Nacionalni programi prevencije zaraznih i nezaraznih bolesti

Javnozdravstveni cilj programa prevencije kako zaraznih tako i nezaraznih bolesti jest prevenirati bolest, smanjiti njezinu incidenciju i smrtnost, a posljedično tome unaprijediti zdravlje pojedinca i populacije u cjelini. Republika Hrvatska se pokretanjem i provođenjem programa prevencije svrstala u skupinu zemalja koje aktivno brinu o zdravlju svog stanovništva. Dobro koncipirani programi temelj su zdravstvene zaštite, oni su dugoročno gledano najučinkovitije i najjeftinije sredstvo u borbi protiv navedenih bolest

CanScreen5, a global repository for breast, cervical and colorectal cancer screening programs

The CanScreen5 project is a global cancer screening data repository that aims to report the status and performance of breast, cervical and colorectal cancer screening programs using a harmonized set of criteria and indicators. Data collected mainly from the Ministry of Health in each country underwent quality validation and ultimately became publicly available through a Web-based portal. Until September 2022, 84 participating countries reported data for breast (n = 57), cervical (n = 75) or colorectal (n = 51) cancer screening programs in the repository. Substantial heterogeneity was observed regarding program organization and performance. Reported screening coverage ranged from 1.7% (Bangladesh) to 85.5% (England, United Kingdom) for breast cancer, from 2.1% (Côte d’Ivoire) to 86.3% (Sweden) for cervical cancer, and from 0.6% (Hungary) to 64.5% (the Netherlands) for colorectal cancer screening programs. Large variability was observed regarding compliance to further assessment of screening programs and detection rates reported for precancers and cancers. A concern is lack of data to estimate performance indicators across the screening continuum. This underscores the need for programs to incorporate quality assurance protocols supported by robust information systems. Program organization requires improvement in resource-limited settings, where screening is likely to be resource-stratified and tailored to country-specific situations.</p

Croatian success in early breast cancer detection: favorable news in Breast Cancer Awareness Month

Breast cancer is the third most common malignant cause of death in women in Croatia, preceded by lung and colorectal cancer. According to the last available data, in 2017 breast cancer was diagnosed in 2767 patients (rate 132.1/100,000), and in 2019, 752 women died from the disease (rate 35.9/100,000). However, the number of deaths has been steadily decreasing for four years in a row (2,3). If we compare the Croatian estimates with those from the European Union (EU-27) countries, we can see that Croatia is near the EU-27 average according to cancer burden (15th out of 27 countries; 14th in men and 19th in women) and fifth according to cancer mortality. However, when we look only at breast cancer estimates, the situation is much better; standardized breast cancer mortality rates for Croatia are below the EU-27 average (16th out of 27 countries) (1). Although the majority of breast cancer cases are not preventable, it is crucial to make the diagnosis at an early stage, when more than 90% of women can be cured. Mammography screening remains the best and widely validated method of early detection of breast cancer, despite its shortcomings and the emergence of other imaging modalities with high diagnostic accuracy

Results of the National Breast Cancer Screening Program in Croatia (2006-2016)

Aim: To assess the uptake of the Croatian National Breast Cancer Screening Program from 2006 to 2016. ----- Methods: The Croatian National Breast Cancer Screening Program, a biennial program targeting women aged 50-69, started in October 2006. From 2006 to 2016, four cycles were completed. One cycle lasted two years, with the exception of the first cycle, which lasted three years. To determine the number of detected cancers in each cycle, the screening program data were merged with the data of the Croatian National Cancer Registry. Our results were compared with the reference values from the European guidelines for quality assurance in breast cancer screening and diagnosis. ----- Results: Around 150 000 mammography exams were performed every year. The response rates for cycle 1, cycle 2, cycle 3, and cycle 4 were 63%, 57%, 60%, and 59%, respectively. Further assessment rate was 6.5%. Breast cancer was identified in 5583 women, with 4.8 cancers detected per 1000 mammography exams. ----- Conclusion: The National Breast Cancer Screening Program in Croatia reached a substantial proportion of the target group. Yet, additional efforts are needed to reach at least 70% of the target population