A Pilot Colorectal Cancer Study Using Fecal Occult Blood Tests and Colonoscopy to Identify the Weaknesses of the Romanian Public Healthcare System before Implementing National Screening

Abstract

The objective of this study is to investigate the feasibility of colorectal cancer (CRC) screening in the absence of a national screening program using the resources provided by the Romanian healthcare system. Study participants were recruited from adult patients (over 18 years old) registered with a general practitioner from an urban area over a period of 3 years (October 2019 to September 2022). Patients were recruited when they came for a consult at their family physician’s office. The study excluded patients with a medical history of colorectal cancer. Written consent was obtained from the patients who agreed to participate. Patients who agreed to participate were recommended to undergo a fecal occult blood test (FOBT). For those with a positive FOBT result, a colonoscopy was recommended. The study identified a need and willingness of patients to participate in CRC screening when they were informed about it, especially when it involved a noninvasive test such as FOB. We did not anticipate the refusal to perform FOBT in the public healthcare system because the recommendation was made by a GP. We identified a deficit of specialists that can perform colonoscopies in the public healthcare system, insufficient health education, and a lack of dedicated pathways for screening.

The Influence of the COVID-19 Pandemic on Colorectal Cancer Secondary Preventive Healthcare Measures

“…For all of them, it was the first time they heard about colorectal cancer screening. This is a finding of the original study [20]. Patients were already aware of the program by the post-pandemic period [23,24].…”

“…The present retrospective observational study included 169 patients over 18 years old enrolled in a pilot colorectal cancer screening study between October 2019 and April 2023 at Doctor Linda-Nicoleta Bărbulescu's family medicine practice in Craiova, Romania [20].…”

A Scoring Method to Prioritize Fecal Occult Blood Testing as a First Step in Colorectal Cancer Screening in Resource-Limited Settings

“…The study design was described elsewhere [38]. The present retrospective study included 112 patients over 40 years old.…”