KOLOREKTUM.CZ | COLORECTAL CANCER SCREENING [ISSN 1804-0888]
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PARTNERS AND EXPERT GUARANTORS
Partners and expert guarantors: MZ ČR, ČGS, SVL, SPL ČR, ČGPS, ČOS, VIZE

 

Faculty of Medicine, Masaryk University     Institute of Biostatistics and Analyses, Masaryk University
PROJECT SUPPORT
Project support: Roche, Ipsen, Orion Diagnostica, OnkoMaják
For health professionals COLORECTAL SCREENING Screening process

Screening process

All asymptomatic men and women aged over 50 years are eligible for colorectal cancer screening in the Czech Republic. Those individuals who meet the criteria of high-risk groups for colorectal cancer are not eligible for the screening programme. Special surveillance regimes exist for patients with positive personal or family history of colorectal cancer, adenomatous polyps, familial adenomatous polyposis (FAP), hereditary nonpolyposis colorectal cancer (HNPCC), or inflammatory bowel disease (IBD).

The screening programme is divided into two categories, according to age groups of the target population.

A. Asymptomatic individuals aged between 50 to 54

  1. The client visits his/her GP or gynaecologist, who will perform the faecal occult blood test (FOBT). This examination is performed once per year in asymptomatic individuals.
  2. In case of a negative result, FOBT is performed again after one year.
  3. In case of a positive result (FOBT+), the client is referred to a facility performing screening colonoscopy. Screening colonoscopy will be reimbursed from the public health insurance only if the client has been referred by his/her GP.
  4. In case of a negative result of colonoscopic examination, the screening programme will be suspended for 10 years for this client; in this way, the client will automatically fall within the age group aged 55 and over.
  5. In case of a positive result of colonoscopic examination (colorectal neoplasia), further diagnostic and therapeutic procedures follow the recommendations for patients at a high risk of colorectal cancer.

Schéma screeningového procesu

B. Asymptomatic individuals aged 55 and over

Two screening options are available:

  1. repeated FOBT
  2. primary screening colonscopy as an alternative screening option

1. FOBT

  • In case of a negative result (TOKS-), there are two possibilities of further screening process: TOKS repeated every two years, or primary screening colonoscopy.
    In case of a positive result (TOKS+), screening colonoscopy is indicated.

2. Primary screening colonscopy

  • Primary screening colonoscopy is an alternative screening option for those individuals who decided not to undergo FOBT. This examination is reimbursed from the public health insurance for individuals aged over 55. The primary screening colonoscopy is indicated by a GP or by a endoscopist from a respective health care facility. If the examination is indicated by a endoscopist, he/she is obliged to inform the respective GP about this fact.
  • In case of a negative result of primary screening colonoscopy, another colonoscopic examination is indicated after a 10-year interval.
  • In case of a positive result of primary screening colonscopy, further diagnostic and therapeutic procedures follow the recommendations for patients at a high risk of colorectal cancer.

Each participant of the screening programme, who wants the findings by one health care facility to be consulted or verified by another health care facility in an interval shorter than recommended by a doctor or the screening programme, has to pay for this examination (i.e., it is not reimbursed from the public health insurance).

Schéma screeningového procesu

Related issues

 Last updated on 23 February 2015