Original paper

Cancer Causes & Control

, Volume 25, Issue 8, pp 985-997

First online:

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

  • Dolores SalasAffiliated withGeneral Directorate Public HealthCentre for Public Health Research (CSISP), FISABIO Email author 
  • , Mercedes VanaclochaAffiliated withCentre for Public Health Research (CSISP), FISABIO
  • , Josefa IbáñezAffiliated withGeneral Directorate Public HealthCentre for Public Health Research (CSISP), FISABIO
  • , Ana Molina-BarcelóAffiliated withCentre for Public Health Research (CSISP), FISABIO
  • , Vicente HernándezAffiliated withDepartment of Gastroenterology, Complexo Hospitalario Universitario de Vigo
  • , Joaquín CubiellaAffiliated withDepartment of Gastroenterology, Complexo Hospitalario Universitario de Ourense
  • , Raquel ZubizarretaAffiliated withDirectorate for Innovation and Management of Public Health
  • , Montserrat AndreuAffiliated withDepartment of Gastroenterology, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Pompeu Fabra University
  • , Cristina HernándezAffiliated withDepartment of Epidemiology and Evaluation, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM)
    • , Francisco Pérez-RiquelmeAffiliated withGeneral Directorate Public HealthInstitute of Bio-health Research of Murcia (IMIB)
    • , José CruzadoAffiliated withGeneral Directorate Public HealthInstitute of Bio-health Research of Murcia (IMIB)
    • , Fernando CarballoAffiliated withInstitute of Bio-health Research of Murcia (IMIB)Department of Gastroenterology, Virgen de la Arrixaca Universitary Hospital
    • , Luis BujandaAffiliated withDepartment of Gastroenterology, Donostia Hospital-Instituto Biodonostia, CIBERehd, University of Basque Country (UPV/EHU)
    • , Cristina SarasquetaAffiliated withDonostia Hospital-Instituto Biodonostia, REDISSEC
    • , Isabel PortilloAffiliated withBasque Health Service
    • , Mariola de la Vega-PrietoAffiliated withGeneral Directorate of Health Care Programmes, Canary Islands Health Service
    • , Juan Diego MorillasAffiliated withDepartment of Gastroenterology, 12 de Octubre Hospital
    • , Vicente ValentínAffiliated withRegional Office for Oncology Coordination, Consejería de Sanidad
    • , Ángel LanasAffiliated withDepartment of Gastroenterology, IIS Aragón, CIBERehd, University of Zaragoza
    • , Enrique QuinteroAffiliated withDepartment of Gastroenterology, Canarias Universitary Hospital
    • , Antoni CastellsAffiliated withDepartment of Gastroenterology, Hospital Clínic, CIBERehd, Institut d’Investigacions Biomediques August Pi i Sunyer

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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 screening Fecal immunochemical testing Colonoscopy Gender Age