ABSTRACT
FUNDAMENTO Y OBJETIVO: Los programas poblacionales de cribado del cáncer colorrectal con prueba de detección de sangre oculta en heces deben obtener tasas altas de participación y ofrecer unos servicios de calidad. Para conocer los factores que influyen en la participación, la opinión y la satisfacción relacionadas con cada una de etapas, se lleva a cabo una encuesta de satisfacción del Programa de Barcelona. MATERIAL Y MÉTODO: Encuesta telefónica mediante cuestionario diseñado ad hoc a una muestra final de 1.189 personas: 310 no participantes en el Programa (NoP), 553 participantes con resultado negativo del test (PNeg) y 326 participantes con resultado positivo (PPos). RESULTADOS: Destacan las puntuaciones altas obtenidas en claridad de la información en general (8,9 de media, escala 0 a 10) y la atención en la farmacia, su accesibilidad y el papel como centro de recogida y entrega del test (superior a 9,3 de media). Aspectos que no han sido tan bien valorados: la preparación de la colonoscopia (el 41,6% refiere bastantes o muchas molestias, mayor en mujeres y menores de 60 años) y en menor medida la accesibilidad telefónica (27,1% refiere alguna dificultad) y la preocupación al recibir telefónicamente el resultado patológico del test (78,9% refiere alguna preocupación). Conclusiones La valoración que la población hace del Programa es positiva y avala la farmacia como punto de distribución y recogida de kits, así como el papel del farmacéutico. Se revisarán algunos aspectos del proceso de cribado con el fin de mejorar la satisfacción del usuario y, eventualmente, incrementar la participación
BACKGROUND AND OBJECTIVE: Population-based bowel screening programmes with faecal occult blood (FOB) tests need to achieve high uptake rates and offer quality services. We invited participants in the Barcelona Programme to complete a satisfaction survey, in order to explore factors influencing uptake and respondents' opinion and satisfaction with each step of the screening process. MATERIAL AND METHOD: Telephone survey using an ad hoc questionnaire (see annex) administered to a final sample of 1189 people: 310 non-participants in the programme (NoP), 553 participants with a negative test result (PNeg), and 326 participants with a positive result (PPos). RESULTS: High scores were obtained for the clarity of the information provided by the programme (mean 8.9 on a scale 0-10), and for the accessibility and attention at the pharmacy as well as its role as the point for collection and return of FOB test cards (mean >9.3). Aspects that were not so highly rated were: preparation for the colonoscopy (41.6% reported quite a lot or a lot of discomfort), and to a lesser extent telephone accessibility (27.1% reported some difficulties). Participants also expressed concern about receiving a positive test result by telephone (78.9% reported some concern). CONCLUSIONS: Respondents' opinion of the programme was positive overall, and supports the pharmacy as the point for distributing and collecting FOB test cards, as well as the role of the pharmacist in the context of the programme. Some aspects of the screening process will be reviewed in order to improve participant satisfaction and eventually increase uptake
Subject(s)
Humans , Early Detection of Cancer/statistics & numerical data , Colorectal Neoplasms/diagnosis , Community Pharmacy Services/organization & administration , Patient Satisfaction/statistics & numerical data , Patient Compliance/statistics & numerical data , Health Care Surveys/statistics & numerical data , Mass Screening/methodsABSTRACT
BACKGROUND AND OBJECTIVE: Population-based bowel screening programmes with faecal occult blood (FOB) tests need to achieve high uptake rates and offer quality services. We invited participants in the Barcelona Programme to complete a satisfaction survey, in order to explore factors influencing uptake and respondents' opinion and satisfaction with each step of the screening process. MATERIAL AND METHOD: Telephone survey using an ad hoc questionnaire (see annex) administered to a final sample of 1189 people: 310 non-participants in the programme (NoP), 553 participants with a negative test result (PNeg), and 326 participants with a positive result (PPos). RESULTS: High scores were obtained for the clarity of the information provided by the programme (mean 8.9 on a scale 0-10), and for the accessibility and attention at the pharmacy as well as its role as the point for collection and return of FOB test cards (mean >9.3). Aspects that were not so highly rated were: preparation for the colonoscopy (41.6% reported quite a lot or a lot of discomfort), and to a lesser extent telephone accessibility (27.1% reported some difficulties). Participants also expressed concern about receiving a positive test result by telephone (78.9% reported some concern). CONCLUSIONS: Respondents' opinion of the programme was positive overall, and supports the pharmacy as the point for distributing and collecting FOB test cards, as well as the role of the pharmacist in the context of the programme. Some aspects of the screening process will be reviewed in order to improve participant satisfaction and eventually increase uptake.
Subject(s)
Colorectal Neoplasms/diagnosis , Community Pharmacy Services , Early Detection of Cancer , Occult Blood , Patient Satisfaction/statistics & numerical data , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle AgedABSTRACT
BACKGROUND: Common low-penetrance genetic variants have been consistently associated with colorectal cancer risk. AIM: To determine if these genetic variants are associated also with adenoma susceptibility and may improve selection of patients with increased risk for advanced adenomas and/or multiplicity (≥ 3 adenomas). METHODS: We selected 1,326 patients with increased risk for advanced adenomas and/or multiplicity and 1,252 controls with normal colonoscopy from population-based colorectal cancer screening programs. We conducted a case-control association study analyzing 30 colorectal cancer susceptibility variants in order to investigate the contribution of these variants to the development of subsequent advanced neoplasia and/or multiplicity. RESULTS: We found that 14 of the analyzed genetic variants showed a statistically significant association with advanced adenomas and/or multiplicity: the probability of developing these lesions increased with the number of risk alleles reaching a 2.3-fold risk increment in individuals with ≥ 17 risk alleles. CONCLUSIONS: Nearly half of the genetic variants associated with colorectal cancer risk are also related to advanced adenoma and/or multiplicity predisposition. Assessing the number of risk alleles in individuals within colorectal cancer screening programs may help to identify better a subgroup with increased risk for advanced neoplasia and/or multiplicity in the general population.
Subject(s)
Adenoma/genetics , Colorectal Neoplasms/genetics , Genetic Predisposition to Disease/genetics , Polymorphism, Single Nucleotide , Aged , Alleles , Case-Control Studies , Female , Gene Frequency , Genome-Wide Association Study , Genotype , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Risk Assessment/methods , Risk Assessment/statistics & numerical data , Risk FactorsABSTRACT
BACKGROUND & AIMS: The latest generation of fecal immunochemical tests (FIT) allows for quantitation of hemoglobin in feces, allowing for selection of optimal cut-off concentrations. We investigated whether individuals with positive results from quantitative FITs, in combination with other factors, could be identified as being at greatest risk for advanced colorectal neoplasia. METHODS: In a retrospective study, we analyzed data from a consecutive series of 3109 participants with positive results from FITs (≥20 µg/g of feces) included in the first round of the Barcelona colorectal cancer screening program, from December 2009 through February 2012. All participants underwent colonoscopy and were assigned to groups with any advanced colorectal neoplasia or with nonadvanced colorectal neoplasia (but with another diagnosis or normal examination findings). RESULTS: Median fecal hemoglobin concentrations were significantly higher in participants with advanced colorectal neoplasia (105 µg/g; interquartile range, 38-288 µg/g) compared with participants with nonadvanced colorectal neoplasia (47 µg/g; interquartile range, 23-119 µg/g) (P < .001). Positive predictive values for advanced colorectal neoplasia, determined using arbitrary fecal hemoglobin concentrations, differed with sex and age. Multivariate logistic regression analysis identified sex (men: odds ratio [OR], 2.07; 95% confidence interval, 1.78-2.41), age (60-69 y: OR, 1.24; 95% confidence interval, 1.07-1.44), and fecal hemoglobin concentration (>177 µg/g: OR, 3.80; 95% confidence interval, 3.07-4.71) as independent predictive factors for advanced colorectal neoplasia. Combining these factors, we identified 16 risk categories associated with different probabilities of identifying advanced colorectal neoplasia. Risk for advanced colorectal neoplasia increased 11.46-fold among individuals in the highest category compared with the lowest category; positive predictive values ranged from 21.3% to 75.6%. CONCLUSIONS: Fecal hemoglobin concentration, in addition to sex and age, in individuals with positive results from FITs can be used to stratify probability for the detection of advanced colorectal neoplasia. These factors should be used to prioritize individuals for colonoscopy examination.
Subject(s)
Biomarkers, Tumor/analysis , Colorectal Neoplasms/chemistry , Early Detection of Cancer , Feces/chemistry , Hemoglobins/analysis , Mass Screening/methods , Occult Blood , Age Factors , Aged , Colonoscopy , Colorectal Neoplasms/pathology , Female , Humans , Immunochemistry , Logistic Models , Male , Middle Aged , Multivariate Analysis , Odds Ratio , Predictive Value of Tests , Prognosis , Retrospective Studies , Risk Assessment , Risk Factors , Sex Factors , SpainABSTRACT
BACKGROUND: We aimed at describing the smoking prevalence trend among the Catalan population (Spain) from 1982 to 1998, based on a gender perspective analysis. SUBJECTS AND METHOD: Data obtained from the surveys carried out by the Catalan Department of Health in 1982, 1986, 1990, 1994 and 1998 were analysed. Variables included were those related to smoking status, number of daily cigarettes, age and sex of the interviewed, type of tobacco smoked, age at which the first experience with smoking took place and smoking duration. Results are presented as proportions with 95% confidence interval and means with standard deviation. RESULTS: Global smoking prevalence in the 15 to 64 year-old population has remained stable between 1982 and 1998 (percentual variability: 1.1%). In 1998, there were 37.5% smokers. In women, the prevalence rate increased by 53.5% during the same period, reaching an overall prevalence of 30.7% in 1998. Among males, there was a 23.8% reduction, reaching an overall prevalence of 44.4%. The decreasing smoking prevalence trend observed among 15 to 24 year-old males and females until 1994 breaks between 1994 and 1998 so that the prevalence in young people increases in this period. In 1998, 26.1% women smoke light tobacco versus 10.4% males; women smoke an average 13.8 (8.8) daily cigarettes versus 19.7 (12.6) in males; mean smoking duration among women is 13.9 (10.1) years, while it is 22.6 (16.0) years among males. CONCLUSIONS: Despite the important reduction of smoking prevalence observed among males, the smoking prevalence rate of the Catalan population remains high. The situation is particularly unfavourable in young people of both sexes and in women, whose smoking habit has specific characteristics.
Subject(s)
Smoking/epidemiology , Adolescent , Adult , Female , Humans , Male , Middle Aged , Prevalence , Sex Factors , Spain/epidemiologyABSTRACT
FUNDAMENTO: Describir la evolución del hábito tabáquico en la población catalana entre 1982 y 1998, a partir de un análisis de perspectiva de género. SUJETOS Y MÉTODO: Se incluyeron datos de las encuestas llevadas a cabo por el Departament de Sanitat i Seguretat Social en 1982, 1986, 1990, 1994 y 1998. Se analizaron el 'status' de fumador, el número de cigarrillos diarios fumados, la edad y el sexo, así como variables relacionadas con el tipo de tabaco fumado, la edad de inicio y la duración del hábito. Los resultados se presentan como proporciones con sus intervalos de confianza del 95 por ciento y como medias con sus desviaciones estándar. RESULTADOS: La prevalencia global del hábito tabáquico en la población de 15-64 años se mantiene estable entre 1982 y 1998 (variación porcentual de -1,1 por ciento) y se sitúa en un 37,5 por ciento de fumadores actuales en 1998. En las mujeres, la prevalencia se incrementa un 53,5 por ciento durante dicho período y alcanza el 30,7 por ciento en 1998. En los varones se reduce un 23,8 por ciento y alcanza el 44,4 por ciento. Entre 1994 y 1998 se rompe la tendencia decreciente que se había producido hasta entonces en los jóvenes de ambos sexos. En 1998, el 26,1 por ciento de las mujeres fuma tabaco 'light' frente a un 10,4 por ciento de los varones; las mujeres fuman una media de 13,8 (8,8) cigarrillos diarios frente a la media de 19,7 (12,6) cigarrillos que fuman los varones; la media de duración del hábito entre las mujeres es de 13,9 (10,1) años mientras que en los varones es de 22,6 (16,0). CONCLUSIONES: Hasta el año 1998, la prevalencia del hábito tabáquico en Cataluña se mantuvo elevada a pesar de producirse una disminución importante de la masculina. La situación fue particularmente desfavorable para los jóvenes de ambos sexos y las mujeres, cuyo hábito tabáquico presenta características específicas (AU)
