Organisational principles of existing colorectal cancer screening programmes in the world medical practice: literature review and analysis of approaches to evidence based screening model for Ukraine

Abstract

Introduction. The incidence of colorectal cancer (CRC) is increasing worldwide, making it the third most common cancer affecting men and the second most common in women. The mortality rate from CRC increases depending on the stage of the disease, while the 5-year survival rate at stage IV is significantly decreased. Screening can detect colorectal cancer at an early stage of the disease, but it can also prevent the development of the disease by identifying polyps that can be removed before they become malignant. Another proof of the potential benefits of CRC screening is the high prevalence of this pathology among the population, its long preclinical and pre-cancerous periods, and the affordability of treatment. Countries with screening programmes have lower CRC mortality rates than countries without them, which confirms the effectiveness and importance of implementing such a programme, due to the medical and social significance of this pathology. Purpose is to substantiate the necessity of developing a colorectal cancer screening programme in Ukraine. Materials and methods. Using the bibliosemantic method, a number of foreign and national sources of information on the main stages of cancer screening were analysed, including current developments concerning the implementation of colorectal cancer screening. The data from the National Cancer Registry of Ukraine and official statistics of the State Statistics Service of Ukraine on deaths and population were used to substantiate the national screening programme. Results. The organisational principles of colorectal cancer screening programmes worldwide were analysed. The practical significance and economic efficiency of implementing a programme focused on the prevention and early detection of the disease at the national level were considered. Ways to preserve the quality and duration of life, human and financial resources using screening, as well as potential opportunities to reduce public spendings were presented. Population-based screening programme requires an appropriate informational and technical infrastructure, including the development of an invitation, reminder and tracking system for screening results, follow-up and monitoring of clinical outcomes. Conclusions. The implementation of the colorectal cancer screening system in Ukraine should take into account the current initial resources and the condition of the healthcare system, based on the principles of organised, staged population-based screening.