The assessment of knowledge and attitudes of men in Serbia about prostate cancer and possibilities for its early detection and treatment in 2011: a cross-sectional study.

PURPOSE: To assess the knowledge and attitudes of men in Serbia about prostate cancer (PCa) and possibilities for its early detection and treatment in 2011. METHODS: This cross-sectional study included 407 men of various ages and education levels selected randomly and divided in 2 groups according to age (up to 40 and over 40 years). The assessment of knowledge and attitudes was based on a survey made up of 12 multiple choice questions conducted with direct contact with respondents from October 15th to December 15th 2011 with their voluntary consent. The results were evaluated in the total sample and between the groups. RESULTS: Patient groups significantly differed according to knowledge about PCa treatment success (p<0.001) and stage in which PCa is most frequently detected (p<0.001) as well as according to attitudes about community-based interventions for increasing the awareness of PCa (p<0.001). Sixty-one percent of respondents over 50 years hadn't done preventive prostate examination despite recommendations. Ninety percent of all respondents believed the community-based intervention should have been implemented in Serbia to increase the men's awareness of PCa. CONCLUSION: The study reported lack of men's knowledge about PCa in Serbia in 2011, while there was a common agreement among men on the necessity of spreading more information about this disease.

Factors influencing participation in breast cancer opportunistic screening in Belgrade, Serbia.

PURPOSE: To assess the motivation and barrier factors influencing participation of women in opportunistic breast cancer screening in Belgrade, Serbia, and to detect changes in these factors over time. METHODS: A cross-sectional study has been carried out at the Institute for Oncology and Radiology of Serbia in 2009 and 2016 among women aged 40 to 69 years from Belgrade who came at the Institute for opportunistic breast cancer screening. The demographic characteristics, data regarding breast exams practices, screening motivators and barriers and sources of information on breast cancer were collected by self-administered questionnaire. RESULTS: The questionnaire was completed by 478 women in 2009 and 453 in 2016, with increase in women reporting regular mammograms or at least one previous mammogram (from 30.1% to 58.6%, p=0.000). In 2009, the most frequent motivating factors were health maintenance (36%), friend's advice, TV, cancer in the family or fear of breast cancer; in 2016, advice from gynecologist (significant increase from 10.9% to 37.7%, p=0.000), health maintenance, family cancer and fear of cancer. The most frequent reasons for not going to exams regularly were absence of breast problems, crowded doctor's offices and no family breast cancer. CONCLUSIONS: These findings provide information on motivation and barrier factors that may influence women's decision to participate in opportunistic breast cancer screening. Those factors have changed over time and the role of physicians has increased significantly. Further exploration of motivating and barrier factors and the extent of their association with actual women's behavior would be helpful for the development of interventions to improve organized and opportunistic screening participation.

Vitamin D Deficiency and Associated Factors in Patients with Mental Disorders Treated in Routine Practice.

This research aimed to investigate factors associated with vitamin D deficiency and to provide data about its prevalence in patients suffering from different psychiatric illnesses. The study had a cross-sectional design and it included 220 patients of both genders, aged from 19-81 y, with a wide range of mental disorders (F00-F89), and treated in routine ambulatory and hospital practice. The researchers collected data from three sources: medical records, a study questionnaire and biochemical analysis of patients' serum samples (concentration of vitamin D measured as 25(OH)D, calcium, phosphorus, magnesium, sodium and potassium). Data were analyzed using descriptive statistics, methods for hypothesis testing and binary logistic regression, at the p≤0.05 level. A total of 140 patients (64%) had a deficiency of vitamin D (<12 ng/mL), and 45 (20%) had inadequate vitamin D serum levels (12-20 ng/mL), while 35 (16%) had sufficient vitamin D serum concentrations (>20 ng/mL). Among variables related to demographics, life style habits, mental illness, comorbid disorders and drugs, two of them, female gender (odds ratio (OR)=2.5, 95% confidence interval (CI)=1.3-4.9, p=0.006) and using clozapine (OR=15.6, 95% CI 1.7-144.7, p=0.02), were significantly associated with vitamin D deficiency. Physical activity (OR= 0.4, 95% CI 0.2-0.9, p=0.02), exercising (OR=0.2, 95% CI <0.1-0.7, p=0.02) and offal in the diet (OR=0.5, 95% CI 0.3-0.9, p=0.03) significantly aggregated in the patients who had a 25(OH)D serum concentration above the deficiency cut-off level. Patients with mental disorders are at high risk for vitamin D deficiency, particularly females and clozapine users as well as those having no adequate physical activity or dietary habits.

New software for collecting data from the organized cervical cancer screening program in Serbia. Are we on the threshold of a new screening registry? - A multicentric study.

PURPOSE: The purpose of this study was to present the Screening Registry and the results of organized cervical cancer screening program (OCCSP) in the Republic of Serbia using a database made as an output model, linked with the Screening Registry. METHODS: Data were respectively collected over a onemonth period from 3 state primary health care centers (and related hospitals/clinical center) in central Serbia in which OCCSP was conducted. The sample consisted of women of the target population (25 to 64 years old) who responded the call for Pap test. RESULTS: The most frequent abnormal cytological diagnosis was in the 38-50 years age group, and consisted of atypical squamous cells of undetermined significance - ASCUS (7.5%) and low grade squamous intraepithelial lesions - L-SIL (7.3%). The most frequent abnormal colposcopic finding in the youngest age group of women (25-37 years) was iodine negative epithelium (35.7%) and in the group of women aged 38-50 and 51-64 years acid-white epithelium. The most common histopathological diagnosis was L-SIL. Positive predictive value of colposcopy in relation to the Pap test was 0.64 (95% CI=0.56-0.70). Interrater agreement (between cytotechnicians and supervisors) measured by the Cohen's coefficient was 0.94 (95% CI=0.91 to 0.97), but between cytology (supervisors) and pathology findings it was 0.83 (95% CI = 0.67 to 0.99). CONCLUSION: The existence of a screening registry contributes to a better epidemiological surveillance of a screening program, and to a possibility for development of various epidemiological researches.

Determinants of smoking and smoking cessation among health professionals in Serbia: A cross-sectional study.

BACKGROUND/AIM: Bearing in mind a high smoking prevalence in Serbia (34% in adult population; men 38%, women 30%) and leading role of health professionals in intervention and prevention, a cross-sectional study was performed smong the representative sample of health professionals in Serbia. The aim of the study was to identify predictors of smoking and smoking cessation prior to the total smoking ban in November 2010. METHODS: In this nationwide study, 3,084 physicians and nurses from 4 types of institutions and four geographical regions were selected and 2,282 included (response rate 74.0%). Data were collected using a self-administered structured questionnaire. Standard statistical methods were used to calculate prevalence rates, and multivariate logistic regressions to evaluate independent predictors of smoking pattern. Risks were expressed as odds ratios (OR) which represent approximation of relative risks of exposed persons with 95% confidence intervals (95% CI). RESULTS: We found a high smoking prevalence of 38.0%, the same for women and men (37.8% and 37.6%, respectively; p = 0.138), higher among nurses (41.7%) than physicians (29.1%) (p = 0.000), as well as among those employed in general hospitals (42.6%) and institutes of public health (43.8%) (p = 0.000). Significantly increased risk of being an ever or current smoker was noticed for nurses (OR = 1.75, 95% CI 1.42-2.14; and OR = 1.91, 95% CI 1.52-2.40, respectively), those employed in general hospitals (OR = 1.37, 95% CI 1.09-1.73 and OR = 1.40, 95% CI 1.09-1.79, respectively), and with worse self-estimated health (OR = 1.15, 95% CI 1.02-1.30; and OR = 1.17, 95% CI 1.02-1.34, respectively). Intentions to quit smoking or to reduce the number of cigarettes were more frequent in women (OR = 1.51, 95% CI 1.01-2.27) and participants who worse evaluated their health (OR = 1.74, 95% CI 1.39-2.18). CONCLUSION: High smoking prevalence in health professionals could be a barrier for the full implementation of smoking ban in health institutions in Serbia. Smoking cessation programs at workplaces, formal education in smoking cessation techniques, and better Law enforcement by health administrations should be implemented.