Evaluation of colorectal cancer early detection status in Uzbekistan.

Abstract

Introduction: In 1992 incidence rate was 0.9 per 100 thousand population. In 2015 this number increased almost 4 times (3.6 per 100 thousand). However, the detection of colorectal cancer in III and IV stages remained almost the same in past 25 years - 55.4% of colorectal cancer patients were diagnosed in late stages in 2016. Data from 1992-2015, indicates an annual increase in the incidence of CRC. Therefore, the aim of the study is to evaluate the status of early detection with determining the obstacles for diagnostics. Methods: We conducted a special survey questionnaire in 2016. Studies were conducted in 675 patients with colorectal cancer diagnosis. Mean age was 58.6. Among them, men were 303, and women were 372. Patients were surveyed in different stages I stage 48 patients, II stage 133 patients, III stage 271 patients, IV stage 223patients. The survey questionnaire included the following questions: age, the presence of CRC in blood relatives, anamnesis, the reasons for the late visit to the doctor, whether the patient is distrustful towards doctors, receiving alternative treatment, pain in the colonoscopy, irrigography, awareness about measures for the prevention, the costs of the routine check-ups. Also, they were asked about using fecal occult blood test as a primary examination. Results: Most of the patients in late stages did not have routine health check-ups. Women denied going to doctor more than men. All of the patients feared of having cancer. Based on questionnaires, we found that 279 (41.4%) of the colorectal cancer patients in our country lack oncological alertness. Many hesitate to contact a doctor with this pathology. More than 118 (17.4%) of patients found all examinations (rectoscopy, colonoscopy, irrigography) painful measuring pain status 4-9 in 10 centigrade scale. None of the patients knew about FOBT as an examination. 154 (22.8%) of patients had distrust towards doctors, and did not attend them. 124 (18.4%) noted the high cost of the clinical examinations, preliminary preparation for it with enema. Some of the patients did not receive early treatment due to presence of colostomy. Conclusion: Early diagnosis of CRC in our country remain at a low level. Firstofall, this is due to the lack of public awareness. Taking into consideration mentality of our region, most of the population, especially women, is shy and afraid to visit doctors, especially oncologists, which significantly reduce the detection of this pathology at an early stage. To improve the early diagnosis of CRC, it is necessary to conduct advertising campaigns in the media on the issue of CRC. Departure of highly qualified specialists to the regions of the country, with the purpose of informing the public, is the one of the key factors of timely contact with a doctor for the prevention of CRC. Adequate pain control measures are needed during examination. In absence of severe intestinal obstruction polyethylene glycol is more convenient than enema. Conducting a screening test for feces for occult blood will also improve the early diagnostics of CRC.