Cancer Causes & Control

, Volume 25, Issue 8, pp 985–997

Participation and detection rates by age and sex for colonoscopy versus fecal immunochemical testing in colorectal cancer screening

Authors

    • General Directorate Public Health
    • Centre for Public Health Research (CSISP)FISABIO
  • Mercedes Vanaclocha
    • Centre for Public Health Research (CSISP)FISABIO
  • Josefa Ibáñez
    • General Directorate Public Health
    • Centre for Public Health Research (CSISP)FISABIO
  • Ana Molina-Barceló
    • Centre for Public Health Research (CSISP)FISABIO
  • Vicente Hernández
    • Department of GastroenterologyComplexo Hospitalario Universitario de Vigo
  • Joaquín Cubiella
    • Department of GastroenterologyComplexo Hospitalario Universitario de Ourense
  • Raquel Zubizarreta
    • Directorate for Innovation and Management of Public Health
  • Montserrat Andreu
    • Department of Gastroenterology, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM)Pompeu Fabra University
  • Cristina Hernández
    • Department of Epidemiology and Evaluation, Hospital del MarHospital del Mar Medical Research Institute (IMIM)
  • Francisco Pérez-Riquelme
    • General Directorate Public Health
    • Institute of Bio-health Research of Murcia (IMIB)
  • José Cruzado
    • General Directorate Public Health
    • Institute of Bio-health Research of Murcia (IMIB)
  • Fernando Carballo
    • Institute of Bio-health Research of Murcia (IMIB)
    • Department of GastroenterologyVirgen de la Arrixaca Universitary Hospital
  • Luis Bujanda
    • Department of Gastroenterology, Donostia Hospital-Instituto Biodonostia, CIBERehdUniversity of Basque Country (UPV/EHU)
  • Cristina Sarasqueta
    • Donostia Hospital-Instituto BiodonostiaREDISSEC
  • Isabel Portillo
    • Basque Health Service
  • Mariola de la Vega-Prieto
    • General Directorate of Health Care ProgrammesCanary Islands Health Service
  • Juan Diego Morillas
    • Department of Gastroenterology12 de Octubre Hospital
  • Vicente Valentín
    • Regional Office for Oncology CoordinationConsejería de Sanidad
  • Ángel Lanas
    • Department of Gastroenterology, IIS Aragón, CIBERehdUniversity of Zaragoza
  • Enrique Quintero
    • Department of GastroenterologyCanarias Universitary Hospital
  • Antoni Castells
    • Department of Gastroenterology, Hospital Clínic, CIBERehdInstitut d’Investigacions Biomediques August Pi i Sunyer
Original paper

DOI: 10.1007/s10552-014-0398-y

Cite this article as:
Salas, D., Vanaclocha, M., Ibáñez, J. et al. Cancer Causes Control (2014) 25: 985. doi:10.1007/s10552-014-0398-y

Abstract

Purpose

To compare two strategies for colorectal cancer screening: one-time colonoscopy versus fecal immunochemical testing (FIT) (and colonoscopy for positive) every 2 years, in order to determine which strategy provides the highest participation and detection rates in groups of sex and age.

Methods

This analysis was performed with data from the first screening round within the COLONPREV study, a population-based, multicenter, nationwide trial carried out in Spain. Several logistic regression models were applied to identify the influence of the screening test on participation rates and detection of proximal and distal neoplasms, as well to identify the influence of age and sex: women aged 50–59 years, women aged 60–69 years, men aged 50–59 years, and men aged 60–69 years.

Results

Participation was higher in women than in men, especially among women aged 50–59 years (25.91 % for colonoscopy and 35.81 % for FIT). Crossover from colonoscopy to FIT was higher among women than men, especially among those aged 60–69 years (30.37 %). In general, detection of any neoplasm and advanced adenoma was higher with colonoscopy than with FIT, but no significant differences were found between the two strategies for colorectal cancer detection. Detection of advanced adenoma in both arms was lower in women [specifically in women aged 50–59 years (OR 0.31; 95 % CI 0.25–0.38) than in men aged 60–69 years]. Women aged 50–59 years in the colonoscopy arm had a higher probability of detection of advanced adenoma (OR 4.49; 95 % CI 3.18–6.35), as well as of detection of neoplasms in proximal and distal locations (proximal OR 19.34; 95 % CI 12.07–31.00; distal OR 11.04; 95 % CI 8.13–15.01) than women of the same age in the FIT arm. These differences were also observed in the remaining groups but to a lesser extent.

Conclusion

Women were more likely to participate in a FIT-based strategy, especially those aged 50–59 years. The likelihood of detection of any neoplasm was higher in the colonoscopy arm for all the population groups studied, especially in women aged 50–59 years. Distinct population groups should be informed of the benefits of each screening strategy so that they may take informed decisions.

Keywords

Cancer colorectal screeningFecal immunochemical testingColonoscopyGenderAge

Copyright information

© Springer International Publishing Switzerland 2014