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Gastroenterol Res Pract. 2015;2015:672410. doi: 10.1155/2015/672410. Epub 2015 Feb 24.

Interval cancers in a population-based screening program for colorectal cancer in catalonia, Spain.

Author information

1
Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
2
Barcelona Health Region, CatSalut, 08023 Barcelona, Spain.
3
Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain ; Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), 28029 Madrid, Spain.
4
Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain ; Department of Fundamental Care and Medical-Surgical Nursing, University of Barcelona, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
5
Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain ; Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), 28029 Madrid, Spain ; Department of Clinical Sciences, University of Barcelona, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.

Abstract

OBJECTIVE:

To analyze interval cancers among participants in a screening program for colorectal cancer (CRC) during four screening rounds.

METHODS:

The study population consisted of participants of a fecal occult blood test-based screening program from February 2000 to September 2010, with a 30-month follow-up (n = 30,480). We used hospital administration data to identify CRC. An interval cancer was defined as an invasive cancer diagnosed within 30 months of a negative screening result and before the next recommended examination. Gender, age, stage, and site distribution of interval cancers were compared with those in the screen-detected group.

RESULTS:

Within the study period, 97 tumors were screen-detected and 74 tumors were diagnosed after a negative screening. In addition, 17 CRC (18.3%) were found after an inconclusive result and 2 cases were diagnosed within the surveillance interval (2.1%). There was an increase of interval cancers over the four rounds (from 32.4% to 46.0%). When compared with screen-detected cancers, interval cancers were found predominantly in the rectum (OR: 3.66; 95% CI: 1.51-8.88) and at more advanced stages (P = 0.025).

CONCLUSION:

There are large numbers of cancer that are not detected through fecal occult blood test-based screening. The low sensitivity should be emphasized to ensure that individuals with symptoms are not falsely reassured.

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