Colorectal and interval cancers of the Colorectal Cancer Screening Program in the Basque Country (Spain)

AIM To assess proportions, related conditions and survival of interval cancer(IC).METHODS The programme has a linkage with different clinical databases and cancer registers to allow suitable evaluation. This evaluation involves the detection of ICs after a negative faecal inmunochemical test(FIT), interval cancer FIT(IC-FIT) prior to a subsequent invitation, and the detection of ICs after a positive FIT and confirmatory diagnosis without colorectal cancer(CRC) detected and before the following recommended c o l o n o s c o p y, I C-c o l o n o s c o p y. W e c o n d u c t e d a retrospective observational study analyzing from January 2009 to December 2015 1193602 invited people onto the Programme(participation rate of 68.6%).RESULTS Two thousand five hundred and eighteen cancers were diagnosed through the programme, 18 cases of IC-colonoscopy were found before the recommended follow-up(43542 colonoscopies performed) and 186 IC-FIT were identified before the following invitation of the 769200 negative FITs. There was no statistically significant relation between the predictor variables of ICs with sex, age and deprivation index, but there was relation between location and stage. Additionally, it was observed that there was less risk when the location was distal rather than proximal(OR = 0.28, 95%CI: 0.20-0.40, P < 0.0001), with no statistical significance when the location was in the rectum as opposed to proximal. When comparing the screen-detected cancers(SCs) with ICs, significant differences in survival were found(P < 0.001); being the 5-years survival for SCs 91.6% and IC-FIT 77.8%.CONCLUSION These findings in a Population Based CRC Screening Programme indicate the need of population-based studies that continue analyzing related factors to improve their detection and reducing harm.

Food groups, diet quality and colorectal cancer risk in the Basque Country

BACKGROUND The results obtained to date concerning food groups,diet quality and colorectal cancer(CRC)risk vary according to criteria used and the study populations.AIM To study the relationships between food groups,diet quality and CRC risk,in an adult population of the Basque Country(North of Spain).METHODS This observational study included 308 patients diagnosed with CRC and 308 ageand sex-matched subjects as controls.During recruitment,dietary,anthropometric,lifestyle,socioeconomic,demographic and health status information was collected.Adherence to the dietary recommendations was evaluated utilizing the Healthy Eating Index for the Spanish Diet and the MedDietScore.Conditional logistic regressions were used to evaluate the associations of food group intakes,diet quality scores,categorized in tertiles,with CRC risk.RESULTS The adjusted models for potential confounding factors showed a direct association between milk and dairy products consumption,in particular high-fat cheeses[odds ratio(OR)third tertile vs first tertile=1.87,95%confidence intervals(CI):1.11-3.16],and CRC risk.While the consumption of fiber-containing foods,especially whole grains(OR third tertile vs first tertile=0.62,95%CI:0.39-0.98),and fatty fish(OR third tertile vs first tertile=0.53,95%CI:0.27-0.99)was associated with a lower risk for CRC.Moreover,higher MD adherence was associated with a reduced CRC risk in adjusted models(OR third tertile vs first tertile=0.40,95%CI:0.20-0.80).CONCLUSION Direct associations were found for high-fat cheese,whereas an inverse relation was reported for fiber-containing foods and fatty fish,as well as adherence to a Mediterranean dietary pattern.