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Delegation of the European Union to the Republic Of Serbia
A project funded by the European Union Contract Nº: 2010/258-562 (09SER01/05/11)
Republic of Serbia Ministry of Economy and Regional Development
National Agency for Tourism Development
Project Office: Dr Subotića 5, Institute for Public Health fo Serbia, "Dr Milan Jovanović - Batut", 11000 Belgrade, Serbia
Tel: (+ 381) 11 20 62 733, Email: office@screeningserbia.rs
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Why cancer screening?

The primary purpose of early detection (screening) for cancer is to reduce the mortality and improve the quality of life of the patient. Early detection is not yet possible for all types of cancer, but is for some of the most common types: breast cancer, cervical and colorectal cancer.

Mortality from breast cancer, cervical and colorectal cancer in Serbia exceeds the European average and represents a significant share in the overall mortality rate from malignant diseases and in the burden of disease.

The number of new cervical cancer cases is more than 1.700 - 1.800 per year. Standardized mortality rate in 2006 was 9,98 per 100.000, corresponding to 3rd - 4th highest rate among the European countries. More than two thirds of new cervical cancers are detected only after the early invasive phase and the prognosis of these cases is poor accordingly.

Breast cancer makes up 30% of all newly discovered cases of cancer and represents the third most common cause of death among women aged above 45. Every twelfth woman in Serbia is diagnosed with breast cancer and every year over 1,300 women in Serbia die from it. 70% of new breast cancers are larger than 2 cm when detected and have already spread to other tissues.

The death rate attributed to the cancers of colorectal origin is exceeding the EU average by 15% in male, and by 19% in the case of female patients. Colorectal cancers lead to the death of 2,400 citizen per year and are the second leading cause of death from cance for both genders. The number of new cases is approximately 3,800 per year.

These data indicate the potential health gain from a well organized early detection system in the country. The number of saved lives, within a single year, could be measured in thousands. The early diagnosis and treatment of cervical, breast and colorectal cancer can have a considerable effect on reducing the cancer-related preventable mortality overall and on improving the health of the Serbian population.

Cancer screening work in Serbia to date

National guideline "Prevention of malignant diseases" was prepared in 2005 by the Working Group appointed by the Ministry of Health of the Republic of Serbia. It includes recommendations for primary prevention of cancer and early detection of breast cancer, cervical cancer and colon cancer. In 2009, the fight against cancer and specifically against colorectal, cervical and breast cancer, has been shaped and endorsed by the authorities in Serbia through the development of the following national programmes:

These Programmes have been formulated in line with WHO recommendation : “to reduce the number of the new cases and mortality rate from cancer, and to improve the quality of life for cancer patients in the country, through a systematic and equitable implementation of evidence-based prevention, early detection, treatment and palliation and the best use of available resources.”

These documents gave new momentum to efforts to counteract cancer in Serbia. They outline the development of technical, organisational and administrative capacities, define responsibilities and coordinate activities of the relevant actors. They enjoy full governmental support and endorsement of key professional and societal stakeholders.

However, except for a few pilot projects, none of these programmes has been implemented on the local or national level and there is no institutional framework for a systemic approach to cancer screening. The existing screening is opportunistic, covering only about 20% of the potential population eligible to participate in the screening programmes for breast, cervical and colorectal cancer.