Frequently asked questions

1. What is colorectal cancer?
   Colorectal cancer is a disease in which cells in the colon or rectum become abnormal and divide without control, forming a mass called a tumor.
   Colorectal cancer cells may also invade and destroy the tissue around them. In addition, they may break away from the tumor and spread to form new tumors (methastasis) in other parts of the body.
2. Who is at risk of developing colorectal cancer?
   The exact causes of colorectal cancer are not known. However, studies have shown that certain factors are linked to an increased chance of developing this disease including the following:
   • ​Age—Colorectal cancer is more likely to occur as people get older. Although this disease can occur at any age, most people who develop colorectal cancer are over 50.
   • A genetic syndromes such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome). Persons with these syndromes have great risk to develop colorectal cancer at young age.
   • Personal history—A person who has already had colorectal cancer is at an increased risk of developing colorectal cancer again.
   • Family history—Close relatives (parents, siblings, or children) of a person who has had colorectal cancer are somewhat more likely to develop this type of cancer themselves, especially if the family member developed cancer at a young age.
   • Inflamatory bowel diseases - Ulcerative colitis or Crohn disease.
   • Diet—Some evidence suggests that the development of colorectal cancer may be associated with high dietary consumption of red meats and animal fat and low consumption of whole grains, fruits, and vegetables.
   • Exercise—Some evidence suggests that lack of physical activity may be associated with an increased risk of developing colorectal cancer.
   • Smoking of cigarretes—  particularly long-term smoking, increases risk for colorectal cancer development.
3. What is colorectal cancer screening?
   It is early detection of unrecognised colorectal cancer in persons without any signs or symptoms.
4. Why should I get screened for colorectal cancer?
   Colorectal cancer screening saves lives. Screening tests can detect polyps, so they can be removed before they turn into cancer. Screening tests can also detect colorectal cancer early, when successfull treatment is possible.
5. What are polyps?
   Polyps are abnormal growths that form on the lining of large intestine. They are relatively common in people over the age of 50. Most polyps are benign, but some of them can be transformed into cancer. Detection  and removal  of polyps can prevent  development of the colorectal cancer. 
6. What is FOB test?
   It is the test used for colorectal cancer screening which detects hidden blood in the stool , that can't be seen with the naked eye. The idea behind this test is that blood vessels at the surface of larger colorectal polyps or cancers are often fragile and easily damaged by the passage of feces. The damaged vessels usually release a small amount of blood into the feces, but only rarely is there enough bleeding for blood to be visible in the stool. 
7. How do I get my FOB test?
   If you are 50 - 74 years old, you  will be invited to visit your GP  in Primary health centre at the scheduled time. During that visit your GP will give you FOB test with instruction how to perform the test at home. The FOB test should then be returned to the medical lab in the Primary health centre.
8. Does positive FOBt means that I have  colorectal cancer?
   Positive FOB test means that blood is present in your stool. Although cancer and polyps can cause presence of the blood in the stool, other causes of bleeding can occur, such as hemorrhoids, diverticulosis or inflammatory bowel disease. If this test is positive, a colonoscopy will be needed to find the reason for the bleeding.
9. What is colonoscopy?
   Colonoscopy is an examination  that allows a doctor close look at the inside of the entire large intestine. The doctor is looking for polyps  or signs of cancer. The doctor uses a thin (about the thickness of a finger), flexible, hollow, lighted tube that has a tiny video camera on the end. This tube is called a colonoscope and during examination it is gently inserted inside the colon through anus. Durin examination small amounts of air are puffed into the colon to keep it open and let the doctor see clearly a surface of the large intestine.The exam itself takes about 30 minutes. 
10. Does the colonoscopy hurt?
    This examination is usually not painful. During colonoscopy air is pumped into the cleaned-out colon to keep it open so that the doctor who performs colonoscopy can get the best pictures. The air pressure may cause some discomfort and cramping, but it should not hurt.
11. 11. I'm 60 and I know that some of my neighbours have already received invitation for colorectal cancer screening. Will I get the invitation?
    Organized national program for early detection of colorectal cancer includes all men and women aged 50 to 74 years. The program is introduced gradually in municipalities in the Republic of Serbia, which provided  all necessary conditions for the proper conduct of organized screening for colorectal cancer. One cycle of screening lasts two years and during these two years all women from target population will be invited for screening.
12. 12. I'm under 50 years, but I'm worried about symptoms/ appearance of colorectal cancer in my family. Can I be screened?
    Colorectal Cancer Screening Programme is available only to people aged 50-74 yers. It is not aimed to screen people who are younger or older than this age. If you are worried about symptoms such as a persistent change in bowel habit, pain in your abdomen, blood in stool, tiredness or weight loss, or if you are concerned about your family history, you shouldn't wait for screening. You should speak to your GP, who can arrange for referral to a specialist if necessary.
13. I'm  65 and I'm worried about appearance of blood in my stool? Can I have the FOB test?
    Screening includes only persons without any symptoms. If you have symptoms such as a persistent change in bowel habit (constipation/diarrhoea) , blood in your stool, pain in your abdomen, tiredness or weight loss then you should not wait for invitation for screening , but contact your GP.
14. I suffer from haemorrhoids (piles). Will this interfere with the screening test?
    If you have haemorrhoids (piles)  then there's more chance that you will get a positive result of FOB test . A positive result may be due to blood from your haemorrhoids or from another bowel condition. Anyone with a positive result of FOB test is offered colonoscopy in order to get a diagnosis.