Faecal occult blood screening for colorectal cancer in Serbia

Milena Scepanovic, Olivera Jovanovic, Dusan Keber, Ivan Jovanovic, Dragan Miljus, Goran Nikolic, Bojan Kovacevic, Aleksandra Pavlovic, Predrag Dugalic, Aleksandar Nagorni, Sasa Grgov, Slavko Knezevic, Predrag Milenkovic, Nenad Perisic, Jean Faivre

Colorectal cancer (CRC) is becoming a major public health problem in the Republic of Serbia. Organized mass screening has been shown to decrease CRC mortality and even its incidence. The aim of this study was to assess the acceptability of a faecal immunochemical test for haemoglobin proposed by primary care physicians. From August to November 2013, a pilot study for CRC screening was organized in individuals aged 50 to 74 years. The study included 50 primary healthcare centres from all 25 administrative regions of Serbia. A qualitative immunochromatographic faecal immunochemical test for human haemoglobin detection was used. Overall, 50 894 individuals were invited. The participation rate was 67.8 and 3.4% of the tests were positive. Among individuals with a positive test, 69.7% agreed to undergo colonoscopy. The positive predictive value was 27.1% for adenoma and 14.6% for carcinoma. This was the first CRC screening project encompassing approximately one-third of primary healthcare facilities in all regions across the country. It showed a good response of the target population and satisfactory cooperation of the healthcare professionals involved.