Colorectal Cancer Prevention in Córdoba, Argentina: a multi-methodological approach to strengthen public policies for territorial implementation

Abstract

In Argentina, colorectal cancer (CRC) ranks second in incidence and mortality for both sexes. With a survival rate of over 90% when diagnosed early, the fecal occult blood test is suggested as a population screening method for the population aged 50 to 75 years without specific risks for this pathology, who conform target population (TP). The study aimed to analyze the socio-health profiles of adults in the TP who had access to preventive measures in Córdoba, considering contextual vulnerability indicators at the departmental level; and to identify the main senses associated with barriers and facilitators in access and continuity in CRC prevention, according to health system users.

To do so, indicators were generated and analyzed from census data (2010) and provincial records provided by the CRC Provincial Prevention Program (2018-2023) (n=1445). Chorothetic maps were constructed, X2 and Wilcoxon tests, multiple correspondence factor analysis, and multiple logistic regression models were estimated. Fifteen semi-structured interviews were conducted with users who had made at least one screening-related consultation (residents from both the capital and the inland), and the transcribed interviews were analyzed qualitatively.

The most unfavorable socio-health indicators were observed in the northwestern part of the province, where most people who accessed the screening were from. Associations were identified between belonging to PO risk groups and certain social characteristics such as health coverage and educational level. These socio-health differences were also reflected in the user interviews.

When implementing territorial strategies, consideration should be given to the fact that there are communities with special needs or more impoverished, to which greater dedication, resources, and individual effort should be given by professionals in order to respond efficiently not only to their health problems but simply to their demands. Studies that address and integrate the multiplicity of factors involved in this problem, such as the present one, can generate extremely valuable contributions to public policies for the prevention of CRC.