Ljiljana Mayer, Siniša Varga i Iva Kirac
Episode · #532
ANAMNEZA Ljiljana Mayer, Siniša Varga i Iva Kirac
Guest Ljiljana Mayer, Siniša Varga i Iva KiracHosted by Marijana MatkovićMay 3, 2026
Ljiljana Mayer, Siniša Varga i Iva Kirac
About this episode
What you'll hear in this conversation
Croatia faces a silent public health crisis: colorectal cancer has become the most common form of cancer, with thousands of new cases each year. This conversation brings together a unique panel to discuss the challenge: Dr. Iva Kirac, a surgical oncologist; Dr. Ljiljana Mayer, a biochemist; and Siniša Varga, a former health minister who also speaks from the perspective of a patient. They dissect the complexities of early detection, the shortcomings of current screening programs, and the profound impact of societal stigma on public health outcomes. You will walk away with a deeper understanding of how medical science, public policy, and human behavior intersect in the fight against a major disease.
Insights from the conversation
What to take from this episode
01
Croatia's colorectal cancer rates have climbed to the highest among all newly detected cancers, with 3,700 cases in 2019 alone. This isn't just a grim statistic; it reveals a public health system facing a rapidly escalating, systemic challenge that requires a response far beyond individual awareness campaigns.
02
Roughly 20% of colorectal cancer patients are now under 50, but the national screening program only covers ages 50 to 74. Standardized age-based screening creates a dangerous blind spot, missing a growing segment of the population unless personalized risk assessments are introduced to adapt to changing demographics.
03
For individuals with a family history of colorectal cancer, the recommendation is a colonoscopy ten years *before* the age their relative was diagnosed, if that's before 50. The real lesson isn't just 'check your family history,' but that effective prevention shifts from blanket age guidelines to dynamic, personalized risk-based timing.
04
The current guaiac test for colorectal cancer screening has a participation rate of just 25%, meaning three out of four invited individuals do not respond. A technically sound public health program falters when it doesn't account for the practical friction points that deter everyday people from participating.
05
The upcoming fecal immunochemical test (FIT) will eliminate the two-three day dietary restrictions and medication interferences required by the old test. Removing seemingly small, mundane barriers to participation can have a disproportionately large impact on the overall success and reach of a public health initiative.
06
Early breast cancer screening programs initially faced low participation, especially in rural areas, but improved significantly over time with consistent media influence and destigmatization efforts. Public health success is rarely immediate; it's a long game of sustained communication and cultural shifts, not just scientific merit.
07
The stark reality that 'only early detected colorectal cancer is curable' underscores the critical value of screening programs. The true cost of late detection isn't just measured in treatment expenses, but in the lost lives and diminished quality of life that could have been prevented.
08
A significant barrier to colorectal cancer screening is the general 'stigma around anything related to the digestive system and the end part of the intestine.' Public health campaigns often misfire by focusing solely on medical facts when the real obstacle to participation is deep-seated cultural discomfort or shame.