Panic, Nikola (54385649700)Nikola (54385649700)PanicRösch, Thomas (7102457515)Thomas (7102457515)RöschSmolovic, Brigita (56033663200)Brigita (56033663200)SmolovicRadunovic, Miodrag (57203560483)Miodrag (57203560483)RadunovicBulajic, Mirko (7003421660)Mirko (7003421660)BulajicPavlovic-Markovic, Aleksandra (55110483700)Aleksandra (55110483700)Pavlovic-MarkovicKrivokapic, Zoran (55503352000)Zoran (55503352000)KrivokapicDjuranovic, Srdjan (6506242160)Srdjan (6506242160)DjuranovicIlle, Tatjana (24830425500)Tatjana (24830425500)IlleBulajic, Milutin (7003421663)Milutin (7003421663)Bulajic2025-06-122025-06-122015https://doi.org/10.1097/MEG.0000000000000415https://www.scopus.com/inward/record.uri?eid=2-s2.0-84942048352&doi=10.1097%2fMEG.0000000000000415&partnerID=40&md5=55fc0a58b641b0756c0a62a3ec8f0741https://remedy.med.bg.ac.rs/handle/123456789/8055Objectives Colorectal cancer (CRC) is one of the most common malignancies worldwide. The aim of this study was to compare the outcomes of two different screening approaches in a small country (Montenegro, 650 000 inhabitants) with a CRC incidence lower than the European average. Methods Two structured invitation programs were compared with respect to compliance and neoplasia yield: (i) program A focused on first-degree relatives of CRC patients diagnosed in two hospitals (n=206), inviting them for colonoscopy; (ii) program B was an invitation program for fecal occult blood testing, followed by colonoscopy if positive, conducted in University Hospital, Podgorica, Montenegro, on 2760 randomly selected average-risk persons, age 50-74 years, living in a single municipality. Results Of 710 first-degree relatives of 206 CRC patients approached, 540 presented for colonoscopy (76.05% uptake). Overall, 31 were diagnosed with a cancer, 58 with advanced adenoma, and 151 with adenoma in general. In the general screening program, of 2760 individuals invited, 920 underwent fecal immunochemical test (33.3% uptake) and colonoscopy was performed in all 95 positive cases (10.3%); six cancers was found in five patients (one patient had two cancers), 19 patients were diagnosed with advanced adenoma, and 26 with any adenomas. The risk-targeted screening program had a significantly higher yield for cancers in both per invited (31/710 vs. 5/2760, P<0.001) and per eligible person analysis (31/540 vs. 5/920, P<0.001). Conclusion In a low-incidence country with limited resources, it may be advisable to start with CRC screening targeted to risk groups. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.adenomascolonoscopycolorectal cancerfecal occult blood testingscreening