Marija Mašanović

Introduction and objective: Three-day home stool testing for invisible blood (test) for healthy, asymptomatic people of both sexes is performed every two years at the invitation of the National Colon Cancer Screening (NCCSP) in Croatia since 2008. The aim of the paper is to present the characteristics of elderly with a positive test result for the Dubrovnik-Nereva County (DNC) at the age of 65-74 years as part of the 3rd-5th calling cycle. Methods: We used data from the NCCSP IT solution and survey questionnaire that people submitted with test samples in the period April 4th 2016 until May 26th 2023 for the analyzed cycles, processed by descriptive statistical method. Results: The results are shown collectively for all observed cycles, according to gender, for 603 people (326 men and 277 women) with a positive test (7.1% of men and 5.1% of women among those tested). Respondents mostly live in a married or cohabiting union (77.0% of men, 59.9% of women), have a secondary education (47.5% of men and 44.4% of women). According to the body mass index (BMI), most men have increased body mass, 47.5% (39.4% of women). The obese category, BMI > 40, was recorded in 0.9% of men and 1.1% of women. The hereditary component of colon polyps or cancer is noted by 17,5% of men and 19,9% of women. The majority of respondents (78.8% of men and 71.8% of women) have no family inheritance of inflammatory bowel diseases or other malignant diseases (48.8% of men, 42.2% of women). 45.1% of men and 26.7% of women drink one to two glasses of beer or wine every day. A greater share of former smokers was recorded among male respondents 22.7% (11.6% of women). Among smokers, 5.6% of men and 3.6% of women smoke more than 20 cigarettes a day, for more than 30 years. Eating a healthy diet noted 65.0% of men and 76.2% of women and 62.3% of men and 61.4% of women practice moderate physical activity. Symptoms are present in 21.2% of men and 20.9% of women, the most common of which is hard stool in both sexes, followed by blood in the stool in men and abdominal pain in women. Conclusion: The majority of elderly people with a positive test for NCCSP have no symptoms or family history of the disease, their body mass is increased and a third of men are long-term smokers with more cigarettes smoked per day. The results suggest the importance of promoting healthy lifestyles in old age as well as motivating asymptomatic elderly people of this age to undergo preventive examinations.

The Mediterranean diet (MD) is one of the most healthful dietary patterns, beneficial for humans and the environment. However, the MD has recently exhibited a declining trend, especially in younger and less affluent people. This study investigated the association between socioeconomic indicators and adherence to the MD in 4671 adult subjects from Dalmatia, Croatia (age range 18–98 years; 61.9% were women). Additionally, in the follow-up we examined the change in adherence to the MD and in BMI (subsample, N = 1342; 62.5% were women; mean follow-up time of 5.8 years). The adherence to the MD was based on the Mediterranean Diet Serving Score (range 0–24 points, cut-off value ≥ 14 points), with a prevalence in the overall sample of 28.5%. Higher odds of adherence to the MD were recorded in women, older subjects, and those with higher level of objective material status, while it was less likely in the period after economic crisis of 2007–2008. Additionally, we detected no change in adherence to the MD in the follow-up subsample (−8.5%, p = 0.056), but there was an increase in BMI (+6.5%, p < 0.001). We recorded an increase in adherence for nuts (+127.5%), sweets (+112.6%), red meat (+56.4%), and wine (+50.0%), unlike the reduction in adherence for vegetables (−35.1%), fish (−23.4%), white meat (−11.6%), cereals (−10.9%), and dairy products (−9.6%). Similar results were obtained across all quartiles of objective material status. Over time, the absolute change in the MD score was positively associated with female gender, age, higher education, and moderate physical activity, but it was negatively associated with adherence to the MD at baseline. BMI change was positively associated with female gender, and negatively with initial BMI, initial adherence to the MD, and MD change. Our findings point towards a less than ideal adherence to the MD in the general population of southern Croatia, and identify important characteristics associated with adherence change over time, informing necessary interventions aimed at increasing MD uptake.