In the recent decades, the number of cancer cases has risen significantly in all developed countries around the world. In the European Union, unfortunately, the mortality rate of malignant colon and rectal tumors (colorectal or simply colon cancer) is the highest in Hungary.
In Hungary, colorectal cancer is the 2nd most common malignancy among men and the 3rd most common malignancy among women. Mortality due to colorectal cancer is the 2nd after lung cancer in men and 3rd after lung and breast cancer in women. As a result of colon cancer, more than 5,000 people die in Hungary every year and almost 10,000 new cases are registered.
The primary goal of organized cancer screening is to reduce the mortality of the target disease. In addition, an important goal is to improve the quality of life, to detect precancerous conditions or the disease itself as early as possible, and to treat the target disease earlier than without screening.
Malignant colon tumors develop slowly and are mostly asymptomatic in the beginning, so this process can take years, therefore it is possible to detect and screen for symptoms before they appear. Colon tumors belong to the group of tumors that can be easily screened.
Regular participation in targeted (organized) colorectal screening can prevent colon cancer by detecting and removing the precancerous condition (polyps). Colon cancer detected at an early stage is curable. In Hungary the organized colorectal screening started in 2018 with the voluntary joining of general practitioners in the framework of an EFOP-1.8.1 priority project, called "Complex Public Health Screenings".
Eligibility for organized colorectal screening
All men and women between the age of 50 and 70 years with a valid health insurance status who have an average risk of colon cancer, who have not had a colon examination in the last 2 years (exactly: 22 months), who have not had a fecal immunochemical examination and who do not have diagnosed colon cancer and/or inflammatory bowel disease can be invited for colorectal screening.
The steps of colorectal screening
Colon cancer screening consists of two steps:
- fecal occult blood test of stool samples taken on two consecutive days;
- colonoscopy, if the fecal occult blood test is not negative.
The test kit includes all equipment needed for stool sampling, which should be done at home on two consecutive days. A small amount of stool sample should be collected with the tool provided in the package and placed in the sample containers according to the instructions. After this, the two containers must be mailed in the free envelope included in the test kit.
The following must be included in the already addressed envelope:
- containers containing samples placed in a pouch,
- the cut part indicated on the invitation letter, completed with the date of the collection of the 2 samples.
The analysis of the submitted samples and the evaluation of the results are performed in a special immunochemical laboratory of the National Center for Public Health (NNK). If your GP has joined the screening program, the laboratory will send him/her the result electronically and you can inquire about the results from you GP approximately 2 weeks after mailing the sample. If you have joined the screening in an individual way or have received the test kit on a screening bus, the result will be mailed to your address.
Possible results of a fecal occult blood test
A negative result means that there was no hidden (occult) blood in your stool. In this case, you have nothing to do. You will receive an invitation letter for organized colorectal screening every 2 years until the age of 70.
A non-negative result means there was hidden blood in the stool, so additional testing is needed to find out the cause of the bleeding. It is important that in the case of a non-negative finding, colonoscopy should be performed even if you do not experience any symptoms, you have no complaints.
If your test result cannot be evaluated, it means that some technical error has occurred during sampling or sample processing. In this case, if you have received the sampling kit from your GP, he / she will provide another 2 sampling tools to re-take the stool samples. If you have individually joined the organized screening or received the test kit as part of the “Taking Screening Tests in Place” program, NNK will mail another sampling tool to your address.
If blood is found in the submitted stool sample, there may be several reasons for it, it may not be caused by a malignant lesion. It can be caused by bleeding from the stomach or hemorrhoids, benign polyps, and inflammation of the colon. To clarify the source of the bleeding, colonoscopy is required, which examines the inner surface of the colon.
Complete, high-quality colonoscopy
Referral is mandatory for colonoscopy, so patients have to turn to their GP with their fecal blood test result. He / she will make an appointment and will perform the tests required before the screening, and the GP will also prepare the patient for colonoscopy and will prescribe the bowel preparation medications, which you have to take the evening before the procedure.
Laboratories belonging to the screening network that perform colonoscopy can be found at the link below.
How do I get the test kit?
If your GP has joined the organized colorectal screening program and has a co-operation agreement with NNK, the Screening Management Department will send an invitation letter to your permanent address. The invitation letter will include that the patient should contact his/her GP in order to receive the sampling equipment.
If you live in a settlement that is the destination of the “Taking Screening Tests in Place” program, the invitation for organized colorectal screening and the test kit can be received from the NNK staff during the deployment of the screening buses.