Results of the implementation of the National program for early detection of colorectal cancer in the Republic of Serbia for the period from 2013 to 2023
Authors: Nikolić Aleksandra , Kuburović Nikola 
Published: October 2024

Background: The implementation of the National Program for Early Detection of Colorectal Cancer in the Republic of Serbia began in December 2012. The program involves primary health centers, secondary and tertiary healthcare institutions, as well as institutes for public health. These institutes coordinate the work of healthcare institutions within their established territories and report on the results of the program's implementation through monthly and annual reports. The importance of implementing screening programs is reflected both clinically, through timely diagnosis and more effective treatment, reducing the mortality rate from the disease itself, and through monitoring the achieved results to implement measures for improving the colorectal cancer screening process. Colorectal cancer is the third most common cancer, accounting for 10% of all cancer cases worldwide, and the second leading cause of cancer-related deaths. In the Republic of Serbia, in 2022, a total of 5,199 new cases of colorectal cancer were registered, of which 3.146 men and 2.053 women. In the same year, 2.408 people died from this disease, including 1.464 men and 944 women. In 2020, in the European Union member states, 341.419 new cases were registered, with 150.366 women and 191.053 men, and 156.105 deaths, including 68.920 women and 87.185 men. It is estimated that in 2020, there were over 1.9 million new cases of colorectal cancer globally, and over 930,000 deaths. In more developed countries, the incidence is decreasing thanks to screening programs, and the prognosis of the disease depends largely on the stage at which it is diagnosed. Methods and Objectives: The analysis was conducted with the aim of presenting the results, specifically selected process indicators, and assessing the scope and structure of healthcare services provided to the target population of men and women aged 50 to 74 years, within the organized screening for colorectal cancer, observed annually over the period from 2013 to 2023. Data sources included reporting forms from health centers and annual reports from the Cancer Screening Office for the period from 2013 to 2023. Based on the collected data, descriptive and analytical methods were applied in the preparation of this paper. An analysis of selected screening process indicators was conducted annually for the period from 2013 to 2023, to assess the achievement of target values for each indicator and to monitor trends. Results: From 2013 to 2023, monitoring the results of the screening process shows that the number of individuals invited to participate in the screening ranged from the lowest number of 28,490 in 2021 to the highest number of 151,101 in 2023. The values of the coverage indicator ranged from a minimum of 6.80% in 2021 to a maximum of 31.85% in 2023. The analysis of the number of iFOB tests performed shows the lowest value of 15,571 in 2020 and the highest of 82,367 in 2023. The analysis of the number of people who underwent colonoscopy as additional diagnostics shows the lowest value of 382 in 2021 and the highest of 1,774 in 2019. The number of people with removed and confirmed adenomas ranged from a minimum of 85 in 2021 to a maximum of 593 in 2018, and the analysis of the number of people with detected malignant colon tumors ranged from a minimum of 17 in 2020 to a maximum of 123 in 2015 and 111 in 2023. Conclusions: The analysis of the achieved results of the implementation of the National Program for early detection of colorectal cancer in the Republic of Serbia for the period from 2013 to 2023 shows improvements in certain key areas. These improvements result from measures taken to enhance the capacity of the necessary resources for the program's implementation. However, it is essential to continue the ongoing monitoring of the process and the achieved results to reach the target values for all parameters.