DIFFERENT APPROACHES TO COLORECTAL CANCER SCREENING AND GP INVOLVEMENT

Seifert B. (1), Lionis C. (2), Fracasso P. (3), Palka M. (4)

1. The Institute of General Practice,1st Faculty of Medicine, Charles University in Prague, Czech Republic
2. Clinic of Social and Family Medicine, Medical Faculty, University of Crete, Greece.
3. Italy Dpt Gastroenterology, Don Bosco Outpatient Clinic, Roma, Italy
4. Jagiellonian University Medical College Department of Family Medicine, Cracow.

ABSTRACT
INTRODUCTION
Colorectal cancer (CRC) is a leading cause of illness and death in Western world, while current literature is still pondering about the screening benefits on mortality reduction and the effectiveness of population-based intervention programmes that leaves a large room for discussion to general practice/family medicine. Several programmes have already been introduced in Europe, each varying involvement of GPs.

AIMS & METHODS
The aim of this session is a review of current screening strategies for CRC, from the primary care perspective, looking at the implementation of screening strategies in Europe. Primary care experts from Greece, Italy, Poland and the Czech Republic will highlight crucial aspects of CRC screening programmes. The results of a systematic search on effectiveness of GPs and primary care practitioners in implementing CRC screening programmes will be also discussed.

RESULTS 
There is a widespread interest in CRC screening in Europe. National screening programmes have been introduced in several countries, such as Germany, the Czech Republic, Slovakia and Poland and have been seriously considered in other countries, such as Hungary, Austria, Italy, UK, France and The Netherlands. The involvement of GPs varies according to the chosen screening strategy. In the Czech Republic, concerning FOBT based programme, GPs are actually doing the systematic screening in their offices, and have a crucial role in the programme. In Poland GPs play a role in recruitment of patients for colonoscopic screening, but in some countries of Southern Europe approximately only one third of GP population recommended FOBT screening, according to recently published reports.

CONCLUSION
CRC screening is experiencing a rapid expansion and effective programmes are now available. GPs should play a substantial role in CRC screening either by assessing the risk of their patients, explaining the screening options, or by deciding on the most individually- appropriate tactic that is feasible within the organization of their local health care system.