March – Colorectal Cancer Awareness Month

According to the Croatian Institute of Public Health, the Croatian Parliament declared March  “Colorectal Cancer Awareness Month“ in 2022. Since colorectal cancer is one of the leading causes of death worldwide, there is an increasing need to raise awareness and encourage public discussions about it to lower external and environmental factors contributing to its development. This is crucial since many factors are within our control.

Incidence

It is concerning that colorectal cancer was the third most common in men and the second most common among women in 2022. However, it was the second leading cause of cancer-related deaths in 2023. The most common cancer among men is prostate cancer, followed by tracheal, bronchial, and lung cancer, whereas breast cancer remains the most common among women. Analyses show that the colorectal cancer incidence in Croatia is annually increasing by approximately 1.1%, while mortality rates have seen a slight decline of around 0.8%

Risk factors

Risk factors can be categorised as non-modifiable and modifiable risks. Age is a non-modifiable risk factor that increases risk proportionally over time, especially after the age of 40. Genetic predispositions are also non-modifiable, contrary to lifestyle and daily habits, on which we do have an impact. A high-fat diet low in fruits, vegetables, and fibre plays a significant role, along with excessive body weight, little to no physical activity, smoking, and alcohol consumption.

In the early stages, symptoms of colorectal cancer are not highly specific. Hence, they can go unnoticed for a long time. However, some of the warning signs include blood in the stool, a feeling of incomplete bowel emptying, abdominal cramps and pain, changes in bowel habits, unintentional weight loss, increased fatigue, and anaemia.

Colorectal cancer mostly develops slowly from intestinal polyps, which some of them become malignant tumours after they start growing uncontrollably. Those polyps are visible, which is why colorectal cancer can be diagnosed in its initial stages. However, the problem arises when the diagnosis is set in the later stages involving distant metastases, as the chances of a cure are drastically reduced. This highlights how important it is for patients to participate in preventive screenings.

National programme for early detection of colorectal cancer

Screening involves testing or examining healthy individuals to determine if there are already developed precancerous or early stages of the disease before the symptoms are present. The screening test includes individuals aged 50 to 75 years and consists of a faecal occult blood test. Over two years, invitations are being sent to home addresses to encourage people to respond and get themselves tested. Each individual who responds will receive envelopes with test cards for stool sampling. If the faecal occult blood test is positive, the patient is referred for a colonoscopy and further diagnosis.

However, despite this well-structured and organised programme, participation rates among the Croatian population are only 32%, way below the European average. Therefore, people are encouraged to respond to the screening invitations to prevent potential negative health consequences.

Translated by: Dea Radek