[CONTRIBUTION OF FAMILY MEDICINE TO COLORECTAL CANCER PREVENTION AND EARLY DETECTION; FORTY-YEAR EXPERIENCE OF FAMILY MEDICINE DEPARTMENT, OSIJEK HEALTH CENTER].

The paper gives a short presentation of 40 years of experience of Osijek Health Center family physicians in colorectal cancer (CRC) prevention and early detection. Systematic work in the prevention and early detection of cancer includes raising public awareness and knowledge of healthcare issues, educating health professionals, conducting scientific research and contributing to the development and implementation of the National Program for Early Detection of Cancer. Cooperation of the Ministry of Health and Osijek Health Center resulted in issuing brochures entitled Men and Cancer and Women and Cancer in 100,000 copies, and later 20,000 copies of a book entitled Smoking Induced Diseases. Analysis of patients undergoing surgery for CRC at Department of Surgery, Osijek General Hospital during the 1973-1984 period showed a low 5-year and 10-year survival rate. A study of early CRC detection by using fecal occult blood test (FOBT), conducted in Osijek between 1980 and 1984, included 11,431 subjects. Results of the study confirmed FOBT to be an acceptable and reliable method for early CRC detection because of its simple use, general level of acceptance by the population and relatively low cost. Physical examinations aimed at detecting CRC by using FOBT were to be implemented in a planned, systematic manner in high-risk persons (those older than 50). Based on the results of this study, guidelines on cancer control were published in 1993 by teams of primary care physicians, especially family physicians. The Osijek Health Center, specifically its Family Medicine Department, participated in the development and implementation of the National Program for Colorectal Cancer Prevention and Early Detection, which started in 2007. Response to the National Program for Early Detection of Colorectal Cancer in individual counties was under 37%. A project called Early Cancer Detection Model Integrated in Family Medicine Practice, which was implemented in Osijek and included subjects from the 45-49 and 75-84 age groups at risk, revealed that teams of family physicians were motivated to join the national programs for early detection of cancer in Croatia. Experiences of the Osijek Health Center Family Medicine Department in the prevention and early detection of CRC indicated that family physicians were pioneers in activities that had ultimately led to the establishment of a National Program for Colorectal Cancer Prevention and Early Detection in Croatia.