Factors influencing participation in colorectal cancer screening programs in Spain

Vanaclocha-Espí, Mercedes; Ibáñez, Josefa; Molina-Barceló, Ana; Pérez, Elena; Nolasco, Andreu; Font, Rebeca; Pérez-Riquelme, Francisco; Vega, Mariola de la; Arana-Arri, Eunate; Oceja, MaElena; Espinàs, Josep Alfons; Portillo, Isabel; Salas, Dolores

doi:10.1016/j.ypmed.2017.08.019

Cited by 6 publications

(5 citation statements)

References 29 publications

(14 reference statements)

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“…While previous studies in the Spanish population found that women were more likely to participate in CRC cancer screening programmes [24,[47][48][49][50], sex was not associated with having had an FOBT in our study. Regarding country of birth, we found that nonparticipation in the screening programme was associated with being born outside of Spain, which is in line with the findings reported by Rosano et al in 2017 [51].…”

Section: Discussioncontrasting

confidence: 88%

“…The strategies implemented in the autonomous communities with higher coverage include those aimed at improving healthcare access among vulnerable people, identifying the barriers to and facilitators of participation in screening, and reducing inequalities in participation. The associated activities include holding meetings with political leaders of the autonomous communities; sending information to be distributed throughout the municipalities in collaboration with city councils; sending tests to homes and enabling participants to submit samples in all primary care centres; sending tests to care homes; conducting cross-sectional analyses of participants and non-participants to identify their profiles and thus develop specific strategies to increase uptake; increasing participation through informative talks in the press and on the radio; implementing the practice of reminder calls from medical and/or nursing staff; holding talks in collaboration with the Spanish Association Against Cancer (AECC); and ensuring that in all primary care centres, people eligible for screening are educated about its importance before being invited for the test [24,47,49,55,64]. In the autonomous communities with lower participation, these activities are only partially implemented, if at all.…”

Section: Discussionmentioning

confidence: 99%

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Factors Associated with Colorectal Cancer Screening in Spain: Results of the 2017 National Health Survey

Nouni-García

Lara-López

Carratalá‐Munuera

et al. 2022

IJERPH

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This study aimed to determine the CRC screening coverage of people aged between 50 and 69 years who were living in Spain in 2017 and describe the factors associated with not having had a faecal occult blood test (FOBT). A cross-sectional study was performed using data from the Spanish National Health Survey 2017. We analysed 7568 individuals between the ages of 50 and 69 years. The proportion of respondents between 50 and 69 years old who had had an FOBT was 29.0% (n = 2191). The three autonomous communities with the lowest proportion of respondents who had had an FOBT were Extremadura (8.7%, n = 16), Ceuta–Melilla (10.4%, n = 3), and Andalucia (14.1%, n = 186). The variables associated with not having had an FOBT were being 50–54 years old (PR = 1.09; 95% CI 1.04–1.14), having been born outside of Spain (PR = 1.11; 95% CI 1.06–1.16), not having been vaccinated against the flu (PR = 1.09; 95% CI 1.04–1.15), never having had a colonoscopy (PR = 1.49; 95% CI 1.40–1.59), not having had an ultrasound scan in the last year (PR = 1.09; 95% CI1.04–1.14), and not having seen a primary care physician in the last month (PR = 1.08; 95% CI1.04–1.12). The factors associated with not getting an FOBT were young age, having been born outside of Spain, not having been vaccinated against the flu in the last campaign, and not making frequent use of healthcare services.

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Section: Discussioncontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Factors Associated with Colorectal Cancer Screening in Spain: Results of the 2017 National Health Survey

Nouni-García

Lara-López

Carratalá‐Munuera

et al. 2022

IJERPH

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“…The CRIBEA-CIN project is a multicentric retrospective cohort study of participants in CRCSPs carried out in the Valencian Community, Region of Murcia, Canary Islands, and the Basque Country (all located in Spain). The characteristics of these programs can be seen in the study of Vanaclocha-Espi et al, 2017 [23]. This project was born with the aim of studying the balance between predictive indicators of the benefits and adverse effects of CRCSPs.…”

Section: Methodsmentioning

confidence: 99%

Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex

et al. 2021

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In the fecal immunological test, a suitable cut-off value may be selected to classify results as either positive or negative. Our aim is to estimate the optimal cut-off value for detecting colorectal cancer in different age and sex groups. This is a multicentric retrospective cohort study of participants in CRC screening programs with FIT between 2006 and 2012. A total of 545,505 participations were analyzed. Cancers diagnosed outside of the program were identified after a negative test result (IC_test) up until 2014. The Wilcoxon test was used to compare fecal hemoglobin levels. ROC curves were used to identify the optimal cut-off value for each age and sex group. Screening program results were estimated for different cut-off values. The results show that the Hb concentration was higher in colorectal cancer (average = 179.6μg/g) vs. false positives (average = 55.2μg/g), in IC_test (average = 3.1μg/g) vs. true negatives (average = 0μg/g), and in men (average = 166.2μg/g) vs. women (average = 140.2μg/g) with colorectal cancer. The optimal cut-off values for women were 18.3μg/g (50-59y) and 14.6μg/g (60-69y), and 16.8μg/g (50-59y) and 19.9μg/g (60-69y) for men. Using different cut-off values for each age and sex group lead to a decrease in the IC_test rate compared to the 20μg/g cut-off value (from 0.40‰ to 0.37‰) and an increase in the false positive rate (from 6.45% to 6.99%). Moreover, test sensitivity improved (90.7%), especially in men and women aged 50-59y (89.4%; 90%) and women aged 60-69y (90.2%). In conclusion, the optimal cut-off value varies for different sex and age groups and the use of an optimal cut-off value for each group improves sensitivity and leads to a small decrease in IC_tests, but also to a larger increase in false positives.

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“…Almost all studies show a large increase in participation when including the FIT sample kit with the invitation. 8,[11][12][13] One Italian study showed only a modest increase in participation, but this study was performed in previously screened individuals (used to another screening strategy). 14 One French study showed low uptake rates when directly mailing the FOBT.…”

Section: Discussionmentioning

confidence: 99%

Participation in faecal immunochemical testing-based colorectal cancer screening programmes in the northwest of Europe

et al. 2019

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Objective This study compared the participation in four faecal immunochemical testing-based screening programmes for colorectal cancer in Flanders, France, Basque country and the Netherlands, to identify factors to further optimize faecal immunochemical testing programmes. Method Background information and data on performance indicators were collected and compared for the four programmes. Results Invitation method, reminders, funding, faecal immunochemical testing cut-off and follow-up after positive faecal immunochemical testing differed in the four programmes. In France, only an invitation letter is sent by mail, while the sample kit must be collected from the general practitioner. In the other programmes, an invitation letter including the sample kit is sent by mail. Participation rates vary substantially according to the method of invitation, with the highest participation rates in the Netherlands (73.0%) and Basque country (72.4%), followed by Flanders (54.5%) and France (28.6%). Basque country (92.8%) and France (88.4%), the two programmes with most active involvement of general practitioners in referral for colonoscopy, had the highest participation rates for colonoscopy. Conclusions Large differences in screening participation observed between programmes according to the invitation method used suggest that changes to the design of the programme, such as including the sample kit with the invitation, or active involvement of GPs, might increase participation.

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Factors influencing participation in colorectal cancer screening programs in Spain

Cited by 6 publications

References 29 publications

Factors Associated with Colorectal Cancer Screening in Spain: Results of the 2017 National Health Survey

Factors Associated with Colorectal Cancer Screening in Spain: Results of the 2017 National Health Survey

Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex

Participation in faecal immunochemical testing-based colorectal cancer screening programmes in the northwest of Europe

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