Colorectal Cancer prevention through population screening: target group risk profiles. Department of Pocho, Province of Córdoba

Abstract

In Argentina, colorectal cancer (CRC) is the second most common cancer in terms of incidence and mortality (12.2% of the total). Early diagnosis (pre-neoplastic lesions and stage 0) allows a 90% survival rate. To encourage early detection of CRC in Cordoba, a pilot experience (PE) population-based screening using a fecal immunochemical test (iFOBT) among adults aged 50 to 75 years, was designed by the Ministry of Health of the Province; taking place in the Department of Pocho (2018–2019). Objectives: to describe the sociodemographic characteristics and lifestyle habits of PE participants and to identify risk profiles associated with the iFOBT result and risk group: average (AR) or elevated (ER).

The results of the iFOBT and interviews conducted during the implementation of the project were analyzed. Simple descriptive statistics, χ² test, multiple correspondence analysis (MCA), and logistic regressions were calculated.

A total of 265 individuals participated (49.8% women), 19.6% ER and 80.4% AR; positivity rate of the test=19.3%. According to the MCA, the ER group was characterized by obesity, elevated glucose, blood pressure and cholesterol, and no physical activity; while the AR group was characterized by physical activity, eutrophic Body Mass Index and low educational level (EL). Regarding ER, consuming grilled meat was a protective factor (PF) (OR=0.30 - IC95% 0.10-0.86), and being obese was a risk factor (RF) (OR=3.82 - IC95% 1.03-14.08). The iFOBT+ group was characterized by being formed by males, ≤60 years old, with low EL and without health coverage (HC); the iFOBTi- group by being formed by females, ≥60 years old, overweight, HC, and complete secondary school. Regarding the iFOBT outcome, the female sex was a PF (OR=0.13 -IC95% 0.04-0.54) and low EL a RF (OR=8.02-IC95% 1.71-37.56). 

This PE allowed us to characterize a population of adults in an area with low accessibility to the health system, to identify a high burden of morbidity potentially associated with CRC, and to install a screening program with high acceptance, laying the groundwork for future actions.