| Abstract | U svijetu kolorektalni karcinom (CRC) treći je najučestaliji, a drugi najsmrtonosniji karcinom. U Republici Hrvatskoj u žena CRC je drugi najčešći karcinom, a u muškaraca treći najčešći. Godišnje u Hrvatskoj novodijagnosticiranih bolesnika je oko 3400, a umrlih 2100, što CRC čini nakon karcinoma pluća najsmrtonosnijom malignom bolešću u Hrvatskoj. Učestalost je veća u razvijenim zemljama. Sekundarna prevencija CRC-a sastoji se od mjera kojima je cilj smanjiti teške posljedice ove bolesti. Dio sekundarne prevencije je probir, tj. rano i pravovremeno otkrivanje bolesti. Koristi se s ciljem otkrivanja osoba u što ranijem stadiju, a nekad i u stadiju prije početka bolesti. Otkrivanjem karcinoma u ranom stadiju može se smanjiti težina bolesti i smrtnost.
Testovi probira (screening) moraju ispunjavati određene uvjete kao što su jednostavnost i sigurnost, dovoljna osjetljivost i specifičnost, ekonomska učinkovitost, mogućnost daljnjeg djelovanja u slučaju pozitivnosti testa, postojanje precizno definirane bolesti, incidencija mora biti poznata, nastanak bolesti mora biti spor, mora biti omogućena jednakost postupanja te granične vrijednosti za zdrave i oboljele moraju biti poznate.
Danas se za probir CRC-a koriste razni testovi. Postoje testovi iz stolice, endoskopske pretrage, radiološke pretrage te testovi za markere iz krvi. Svaki test ima svoje prednosti i mane. Za probir je bitno odabrati ne samo test koji je najbolji s najvećom osjetljivošću i specifičnošću, već onaj za koji će se najveći dio populacije biti voljan odazvati uz prihvatljive ostale osobine. |
| Abstract (english) | Colorectal carcinoma or colorectal cancer (CRC) is the third most common and the second deadliest cancer in the world. In the Republic of Croatia, CRC is the second most common cancer in women, and the third most common in men. Annually in Croatia, there are about 3,400 newly diagnosed patients and 2,100 deaths, which makes CRC the deadliest malignant disease in Croatia after lung cancer. The frequency is higher in developed countries. Secondary prevention of CRC consists of measures aimed at reducing the serious consequences of this disease. Part of secondary prevention is screening, i.e. early and timely detection of the disease. It is used with the aim of detecting people at an earlier stage, and sometimes at a stage before the onset of the disease. Detecting cancer at an early stage can reduce the severity of the disease and mortality.
Screening tests must meet certain conditions such as simplicity and safety, sufficient sensitivity and specificity, cost-effectiveness, the possibility of further action in the event of a positive test, the existence of a precisely defined disease, the incidence must be known, the onset of the disease must be slow, it must be enabled equality of treatment and cut-off for healthy and sick people must be known.
Today, various tests are used for CRC screening. There are stool tests, endoscopic procedures, radiological imaging and blood marker tests. Each test has its own number of advantages and disadvantages. For screening, it is important to choose not only the best test with the highest sensitivity and specificity, but the one for which the largest part of the population is willing to adhere to, test must have acceptable other characteristics as well. |
