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1. Impact of the COVID-19 pandemic on cervical cancer screening participation, abnormal cytology prevalence and screening interval in Catalonia

Author

Robles, Claudia, primary, Monfil, Laura, additional, Ibáñez, Raquel, additional, Roura, Esther, additional, Font, Rebeca, additional, Peremiquel-Trillas, Paula, additional, Brotons, Maria, additional, Martínez-Bueno, Cristina, additional, de Sanjosé, Silvia, additional, Espinàs, Josep Alfons, additional, and Bruni, Laia, additional

Published
2024
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2. Missing data imputation and synthetic data simulation through modeling graphical probabilistic dependencies between variables (ModGraProDep): An application to breast cancer survival

Author

Vilardell, Mireia, Buxó, Maria, Clèries, Ramon, Martínez, José Miguel, Garcia, Gemma, Ameijide, Alberto, Font, Rebeca, Civit, Sergi, Marcos-Gragera, Rafael, Vilardell, Maria Loreto, Carulla, Marià, Espinàs, Josep Alfons, Galceran, Jaume, Izquierdo, Angel, and Borràs, Josep Ma

Published
2020
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3. Ten-Year Probabilities of Death Due to Cancer and Cardiovascular Disease among Breast Cancer Patients Diagnosed in North-Eastern Spain

Author

Clèries, Ramon, primary, Ameijide, Alberto, additional, Buxó, Maria, additional, Vilardell, Mireia, additional, Martínez, José Miguel, additional, Font, Rebeca, additional, Marcos-Gragera, Rafael, additional, Puigdemont, Montse, additional, Viñas, Gemma, additional, Carulla, Marià, additional, Espinàs, Josep Alfons, additional, Galceran, Jaume, additional, Izquierdo, Ángel, additional, and Borràs, Josep Maria, additional

Published
2022
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5. No Excess Mortality up to 10 Years in Early Stages of Breast Cancer in Women Adherent to Oral Endocrine Therapy: A Probabilistic Graphical Modeling Approach

Author

Clèries, Ramon, primary, Buxó, Maria, additional, Vilardell, Mireia, additional, Ameijide, Alberto, additional, Martínez, José Miguel, additional, Font, Rebeca, additional, Marcos-Gragera, Rafael, additional, Puigdemont, Montse, additional, Viñas, Gemma, additional, Carulla, Marià, additional, Espinàs, Josep Alfons, additional, Galceran, Jaume, additional, Izquierdo, Ángel, additional, and Borràs, Josep Maria, additional

Published
2022
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7. Risk of breast cancer two years after a benign biopsy depends on the mammographic feature prompting recall

Author

Vernet-Tomás, Maria, Louro, Javier, Román, Marta, Saladié, Francina, Posso, Margarita, Prieto, Miguel, Vázquez, Ivonne, Baré, Marisa, Peñalva, Lupe, Vidal, Carmen, Bargalló Castelló, Xavier, Sánchez, Mar, Ferrer, Joana, Espinàs, Josep Alfons, Quintana, María Jesús, Rodríguez Arana, Ana Maria, Castells, Xavier, and BELE Study Group

Subjects
Risk, medicine.medical_specialty, Biopsy, Invasive assessment, false-positive recall, Context (language use), Breast Neoplasms, False-positive recall, Malignancy, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Breast cancer screening, breast cancer risk, 0302 clinical medicine, Breast cancer, medicine, Humans, Mass Screening, False Positive Reactions, 030212 general & internal medicine, Breast, Early Detection of Cancer, mammographic feature, 030219 obstetrics & reproductive medicine, Recall, medicine.diagnostic_test, Obstetrics, business.industry, Outcome measures, Obstetrics and Gynecology, invasive assessment, medicine.disease, Mammographic feature, Feature (computer vision), Spain, Female, business, Breast cancer risk, Mammography
Abstract

Objective: We aimed to explore whether the type of mammographic feature prompting a false-positive recall (FPR) during mammography screening influences the risk and timing of breast cancer diagnosis, particularly if assessed with invasive procedures. Study design: We included information on women screened and recalled for further assessment in Spain between 1994 and 2015, with follow-up until 2017, categorizing FPRs by the assessment (noninvasive or invasive) and mammographic feature prompting the recall. Main outcome measures: Breast cancer rates in the first two years after FPR (first period) and after two years (second period). Results: The study included 99,825 women with FPRs. In both periods, the breast cancer rate was higher in the invasive assessment group than in the noninvasive group (first period 12 parts per thousand vs 1.9 parts per thousand, p < 0.001; second period 4.4 parts per thousand vs 3.1 parts per thousand, p < 0.001). During the first period, the invasive assessment group showed diverse breast cancer rates for each type of mammographic feature, with a higher rate for asymmetric density (31.9 parts per thousand). When the second period was compared with the first, the breast cancer rate decreased in the invasive assessment group (from 12 parts per thousand to 4.4 parts per thousand, p < 0.001) and increased in the noninvasive assessment group (from 1.9 parts per thousand to 3.1 parts per thousand, p < 0.001). Conclusion: In the context of mammography screening, the risk of breast cancer diagnosis during the first two years after FPR was particularly high for women undergoing invasive assessment; importantly, the risk was modified by type of mammographic feature prompting the recall. This information could help to individualize follow-up after exclusion of malignancy.

Published
2021

8. Exceso de mortalidad en las pacientes con cáncer de mama en estadios precoces en Tarragona y Gerona (España) = Excess mortality among breast cancer patients in early stages in Tarragona and Gerona (Spain)

Author

Clèries, Ramon, Ameijide, Alberto, Buxó Pujolràs, Maria, Vilardell, Mireia, Martínez, José Miguel, Marcos-Gragera, Rafael, Vilardell, Maria Loreto, Carulla, Marià, Espinàs, Josep Alfons, Galceran, Jaume, Borràs, Josep M., and Izquierdo i Font, Àngel Xavier

Subjects
Mama -- Càncer -- Mortalitat, Breast -- Cancer -- Mortality
Abstract

To analyze the population-based survival of breast cancer (CM) diagnosed in early stages estimating the time trends of excess mortality (EM) in the long term in annual and five-year time intervals, and to determine, if possible, a proportion of patients who can be considered cured. Method: We included women diagnosed with BC under the age of 60 years in stages I and II in Girona and Tarragona (N = 2453). The observed (OS) and relative survival (RS) were calculated up to 20 years of follow-up. RS was also estimated at annual (RSI) and in five-year intervals (RS5) to graphically assess the EM. The results are presented by age groups (≤49 and 50-59), stage (I/II) and diagnostic period (1985-1994 and 1995-2004). Results: In stage I, OS and RS were higher during 1995-2004 compared to 1985-1994: 3.5% at 15 years of follow-up and 4.5% at 20-years of follow-up. In 1995-2004, the OS surpassed 80% in stage I patients whereas in stage II it remained below 70%. During 1995-2004, the long-term EM did not level off towards 0 (RSI

Published
2020

9. Text messaging as a tool to improve cancer screening programs (M-TICS Study): A randomized controlled trial protocol

Author

Vives, Nuria, primary, Farre, Albert, additional, Ibáñez-Sanz, Gemma, additional, Vidal, Carmen, additional, Binefa, Gemma, additional, Milà, Núria, additional, Pérez-Lacasta, Maria Jose, additional, Travier, Noemie, additional, Benito, Llucia, additional, Espinàs, Josep Alfons, additional, Bagaria, Guillermo, additional, and Garcia, Montse, additional

Published
2021
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11. Biomarkers expression in benign breast diseases and risk of subsequent breast cancer: a case–control study

Author

Posso, Margarita, Corominas, Josep M., Serrano, Laia, Román, Marta, Torá‐Rocamora, Isabel, Domingo, Laia, Romero, Anabel, Quintana, María Jesús, Vernet‐Tomas, María, Baré, Marisa, Vidal, Carmen, Sánchez, Mar, Saladié, Francina, Natal, Carmen, Ferrer, Joana, Servitja, Sònia, Sala, María, Castells, Xavier, Burón, Andrea, Rodríguez‐Arana, Ana, Romero, Ana, Vernet, Mar, Andreu, Xavier, Milà, Núria, López‐Vilaró, Laura, Fernández‐Somoano, Ana, Galceran, Jaume, and Espinàs, Josep Alfons

Subjects
0301 basic medicine, Oncology, Cancer Research, medicine.medical_specialty, Estrogen receptor, Benign breast diseases, Benign breast disease, 03 medical and health sciences, Breast Diseases, 0302 clinical medicine, Breast cancer, breast cancer, Risk Factors, Internal medicine, Progesterone receptor, medicine, Odds Ratio, Humans, Radiology, Nuclear Medicine and imaging, Breast, skin and connective tissue diseases, early detection, Original Research, Aged, business.industry, screening, Case-control study, Cancer, biomarkers, Odds ratio, Middle Aged, medicine.disease, Confidence interval, 030104 developmental biology, Ki-67 Antigen, Receptors, Estrogen, Spain, 030220 oncology & carcinogenesis, Case-Control Studies, Marcadors bioquímics, Mama -- Càncer, Female, business, Receptors, Progesterone, Cancer Prevention
Abstract

Women with benign breast diseases (BBD) have a high risk of breast cancer. However, no biomarkers have been clearly established to predict cancer in these women. Our aim was to explore whether estrogen receptor (ER), progesterone receptor (PR), and Ki67 expression stratify risk of breast cancer in screened women with BBD. We conducted a nested case–control study. Women with breast cancer and prior BBDs (86 cases) were matched to women with prior BBDs who were free from breast cancer (172 controls). The matching factors were age at BBD diagnosis, type of BBD, and follow‐up time since BBD diagnosis. ER, PR, and Ki67 expression were obtained from BBDs’ specimens. Conditional logistic regression was used to estimate odds ratios (ORs), and 95% confidence intervals (CIs) of breast cancer risk according to ER, PR, and Ki67 expression. Women with >90% of ER expression had a higher risk of breast cancer (OR = 2.63; 95% CI: 1.26–5.51) than women with ≤70% of ER expression. Similarly, women with >80% of PR expression had a higher risk of breast cancer (OR = 2.22; 95% CI: 1.15–4.27) than women with ≤40% of PR expression. Women with proliferative disease and ≥1% of Ki67 expression had a nonsignificantly increased risk of breast cancer (OR = 1.16; 95% CI: 0.46–2.90) than women with

Published
2017

12. Risk factors for severe complications of colonoscopy in screening programs

Author

Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Vanaclocha-Espi, Mercedes, Ibáñez, Josefa, Molina-Barceló, Ana, Valverde-Roig, María José, Pérez, Elena, Nolasco, Andreu, Vega, Mariola de la, Diez de la Lastra-Bosch, Isabel, Oceja, María Elena, Espinàs, Josep Alfons, Font, Rebeca, Pérez-Riquelme, Francisco, Arana-Arri, Eunate, Portillo, Isabel, Salas, Dolores, CRIBEA Group, Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Vanaclocha-Espi, Mercedes, Ibáñez, Josefa, Molina-Barceló, Ana, Valverde-Roig, María José, Pérez, Elena, Nolasco, Andreu, Vega, Mariola de la, Diez de la Lastra-Bosch, Isabel, Oceja, María Elena, Espinàs, Josep Alfons, Font, Rebeca, Pérez-Riquelme, Francisco, Arana-Arri, Eunate, Portillo, Isabel, Salas, Dolores, and CRIBEA Group

Abstract

Severe complications (SC) in colonoscopy represent the most important adverse effect of colorectal cancer screening programs (CRCSP). The objective is to evaluate the risk factors for SC in colonoscopy indicated after a positive fecal occult blood test in population-based CRCSP. The SC (n = 161) identified from 48,730 diagnostic colonoscopies performed in a cohort of all the women and men invited from 2000 to 2012 in 6 CRCSP in Spain. A total of 318 controls were selected, matched for age, sex and period when the colonoscopy was performed. Conditional logistic regression models were estimated. The analysis was performed separately in groups: immediate-SC (same day of the colonoscopy); late-SC (between 1 and 30 days after); perforation; and bleeding events. SC occurred in 3.30‰ of colonoscopies. Prior colon disease showed a higher risk of SC (OR = 4.87). Regular antiplatelet treatment conferred a higher risk of overall SC (OR = 2.80) and late-SC (OR = 9.26), as did regular anticoagulant therapy (OR = 3.47, OR = 7.36). A history of pelvic-surgery or abdominal-radiotherapy was a risk factor for overall SC (OR = 5.03), immediate-SC (OR = 8.49), late-SC (OR = 4.65) and perforation (OR = 21.59). A finding of adenoma or cancer also showed a higher risk of overall SC (OR = 8.71), immediate-SC (OR = 12.67), late-SC (OR = 4.08), perforation (OR = 4.69) and bleeding (OR = 17.02). The risk of SC doesn't vary depending on the type of preparation or type of anesthesia. Knowing the clinical history of patients such as regular previous medication and history of surgery or radiotherapy, as well as the severity of the findings during the colonoscopy process could help to focus prevention measures in order to minimize SC in CRCSP.

Published
2019

13. Competing risks to breast cancer mortality in Catalonia

Author

Espinàs Josep-Alfons, Pla Roger, Carles Misericòrdia, Martínez-Alonso Montserrat, Gispert Rosa, Vilaprinyo Ester, and Rué Montserrat

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Breast cancer mortality has experienced important changes over the last century. Breast cancer occurs in the presence of other competing risks which can influence breast cancer incidence and mortality trends. The aim of the present work is: 1) to assess the impact of breast cancer deaths among mortality from all causes in Catalonia (Spain), by age and birth cohort and 2) to estimate the risk of death from other causes than breast cancer, one of the inputs needed to model breast cancer mortality reduction due to screening or therapeutic interventions. Methods The multi-decrement life table methodology was used. First, all-cause mortality probabilities were obtained by age and cohort. Then mortality probability for breast cancer was subtracted from the all-cause mortality probabilities to obtain cohort life tables for causes other than breast cancer. These life tables, on one hand, provide an estimate of the risk of dying from competing risks, and on the other hand, permit to assess the impact of breast cancer deaths on all-cause mortality using the ratio of the probability of death for causes other than breast cancer by the all-cause probability of death. Results There was an increasing impact of breast cancer on mortality in the first part of the 20th century, with a peak for cohorts born in 1945–54 in the 40–49 age groups (for which approximately 24% of mortality was due to breast cancer). Even though for cohorts born after 1955 there was only information for women under 50, it is also important to note that the impact of breast cancer on all-cause mortality decreased for those cohorts. Conclusion We have quantified the effect of removing breast cancer mortality in different age groups and birth cohorts. Our results are consistent with US findings. We also have obtained an estimate of the risk of dying from competing-causes mortality, which will be used in the assessment of the effect of mammography screening on breast cancer mortality in Catalonia.

Published
2008
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14. Hacia la concentración de la cirugía oncológica digestiva: cambios en la actividad, las técnicas y los resultados

Author

Tebé, Cristian, Pla, Roger, Espinàs, Josep Alfons, Corral, Julieta, Puigdomènech, Elisa, Borràs, Josep Maria, Pons, Joan M. V., and Espallargues, Mireia

Subjects
Regionalization, Volume, Clinical-administrative databases, Cirugía oncología digestiva, Digestive oncology surgery, Outcomes, Variations, Resultados, Variaciones, Bases de datos clínico-administrativas, Mortalidad, Volumen, Mortality, Regionalización
Abstract

Aim: The objective of the present study was to examine changes in the activity, surgical techniques and results from the process of centralization of complex digestive oncologic surgery in 2005-2012 as compared to 1996-2000. Material and methods: A retrospective cohort study employing the minimum basic data set of hospital discharge (MBDSHD 1996-2012) from public centers in Catalonia (Spain) was performed. The population consisted of individuals aged > 18 who underwent digestive oncologic surgery (esophagus, pancreas, liver, stomach or rectum). Medical centers were divided into low, medium, and high-volume centers (≤ 5, 6-10, and > 10 interventions/year, respectively). The tendency Chi-squared test was used to assess the centralization of patients in high-volume centers and hospital mortality evolution during the study period. Logistic regression was performed to assess the relationship between volume and outcome. Results: A centralization of complex oncologic digestive surgery between 10% (liver) and 46% (esophagus) was obtained by means of a reduction in the number of hospitals that perform these interventions and a significant rise in the number of patients operated in high-volume centers (all types p ≤ 0.0001, except for esophagus). A significant decrease in mortality was observed, especially in esophagus (from 15% in 1996/2000 to 7% in 2009/12, p = 0.003) and pancreas (from 12% in 1996/2000 to 6% in 2009/12, p trend < 0.0001). Conclusions: A centralization of oncologic digestive surgery in high-volume centers and a reduction of hospital mortality in Catalonia were reported among esophageal and pancreatic cancers. However, no significant changes were found for others cancer types. Objetivo: se examinaron los cambios en actividad, técnicas quirúrgicas y resultados del proceso de concentración de la cirugía oncológica digestiva compleja entre 2005-2012 en relación a 1996-2000. Material y métodos: se realizó un estudio de cohortes retrospectivo a partir del Conjunto Mínimo Básico de Datos (CMBD) al alta hospitalaria (1996-2012) de centros públicos de Catalunya. Población > 18 años intervenida de cáncer de: esófago, páncreas, hígado, estómago y recto. Los centros se clasificaron en: bajo, medio y alto volumen (≤ 5, 6-10 y > 10 procedimientos/año, respectivamente). Utilización del test tendencia Chi-cuadrado para valorar la concentración de pacientes en centros de alto volumen y la evolución de la mortalidad hospitalaria y regresión logística para estudiar la relación entre volumen y resultado en el periodo de concentración (2005-2012). Resultados: se ha producido una progresiva concentración de la cirugía oncológica digestiva compleja, mediante la reducción de entre un 10% (hígado) y 46% (esófago) del número de hospitales que realizan estas intervenciones y el aumento significativo del porcentaje de pacientes intervenidos en centros de alto volumen (todas las p tendencia < 0,0001, excepto esófago). También se observa una reducción significativa de la mortalidad, especialmente en esófago (de 15% en 1996/2000 a 7% en 2009/12, p tendencia = 0,003) y páncreas (de 12% en 1996/2000 a 6% en 2009/2012, p tendencia < 0,0001). Conclusiones: se ha producido una concentración efectiva de la cirugía oncológica digestiva en Cataluña en centros de alto volumen que se ha acompañado de una reducción de la mortalidad hospitalaria clara en esófago y páncreas, aunque sin cambios significativos en los otros cánceres estudiados.

Published
2017

15. Factors influencing participation in colorectal cancer screening programs in Spain

Author

Vanaclocha-Espi, Mercedes, Ibáñez, Josefa, Molina-Barceló, Ana, Pérez, Elena, Nolasco, Andreu, Font, Rebeca, Pérez-Riquelme, Francisco, Vega, Mariola de la, Arana-Arri, Eunate, Oceja, M. Elena, Espinàs, Josep Alfons, Portillo, Isabel, Salas, Dolores, CRIBEA Group, Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, and Grupo Balmis de Investigación en Salud Comunitaria e Historia de la Ciencia

Subjects
Male, medicine.medical_specialty, Epidemiology, Population, Logistic regression, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, medicine, FOBT, Humans, Mass Screening, 030212 general & internal medicine, education, Early Detection of Cancer, Aged, Retrospective Studies, Preventive healthcare, Gynecology, education.field_of_study, business.industry, Fecal occult blood, Public Health, Environmental and Occupational Health, Participation, Retrospective cohort study, Middle Aged, Test (assessment), Spain, Colorectal cancer screening, CCR screening, Occult Blood, 030220 oncology & carcinogenesis, Family medicine, Cohort, Female, Enfermería, Patient Participation, Colorectal Neoplasms, business
Abstract

To analyze the sociodemographic and organizational factors influencing participation in population-based colorectal cancer screening programs (CRCSP) in Spain, a retrospective study was conducted in a cohort of people invited to participate in the first 3 screening rounds of 6 CRCSP from 2000 to 2012. Mixed logistic regression models were used to analyze the relationship between sociodemographic and organizational factors, such as the type of fecal occult blood test (FOBT) used and the FOBT delivery type. The analysis was performed separately in groups (Initial screening-first invitation, Subsequent invitation for previous never-responders, Subsequent invitation-regular, Subsequent invitation-irregular intervals). The results showed that, in the Initial screening-first invitation group, participation was higher in women than in men in all age groups (OR 1.05 in persons aged 50–59 years and OR 1.12 in those aged 60–69 years). Participation was also higher when no action was required to receive the FOBT kit, independently of the type of screening (Initial screening-first invitation [OR 2.24], Subsequent invitation for previous never-responders [OR 2.14], Subsequent invitation-regular [OR 2.03], Subsequent invitation-irregular intervals [OR 9.38]) and when quantitative rather than qualitative immunological FOBT (FIT) was offered (Initial screening-first invitation [OR 0.70], Subsequent invitation for previous never-responders [OR 0.12], Subsequent invitation-regular [OR 0.20]) or guaiac testing (Initial screening-first invitation [OR 0.81], Subsequent invitation for previous never-responders [OR 0.88], Subsequent invitation-regular [OR 0.73]). In conclusion, the results of this study show that screening participation could be enhanced by inclusion of the FOBT kit with the screening invitation and the use of the quantitative FIT. This Project was funded by the Fondo de Investigación Sanitario with cofunding from FEDER [PI12/00944]

Published
2017

16. Factors influencing participation in colorectal cancer screening programs in Spain

Author

Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Vanaclocha-Espi, Mercedes, Ibáñez, Josefa, Molina-Barceló, Ana, Pérez, Elena, Nolasco, Andreu, Font, Rebeca, Pérez-Riquelme, Francisco, Vega, Mariola de la, Arana-Arri, Eunate, Oceja, M. Elena, Espinàs, Josep Alfons, Portillo, Isabel, Salas, Dolores, CRIBEA Group, Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Vanaclocha-Espi, Mercedes, Ibáñez, Josefa, Molina-Barceló, Ana, Pérez, Elena, Nolasco, Andreu, Font, Rebeca, Pérez-Riquelme, Francisco, Vega, Mariola de la, Arana-Arri, Eunate, Oceja, M. Elena, Espinàs, Josep Alfons, Portillo, Isabel, Salas, Dolores, and CRIBEA Group

Abstract

To analyze the sociodemographic and organizational factors influencing participation in population-based colorectal cancer screening programs (CRCSP) in Spain, a retrospective study was conducted in a cohort of people invited to participate in the first 3 screening rounds of 6 CRCSP from 2000 to 2012. Mixed logistic regression models were used to analyze the relationship between sociodemographic and organizational factors, such as the type of fecal occult blood test (FOBT) used and the FOBT delivery type. The analysis was performed separately in groups (Initial screening-first invitation, Subsequent invitation for previous never-responders, Subsequent invitation-regular, Subsequent invitation-irregular intervals). The results showed that, in the Initial screening-first invitation group, participation was higher in women than in men in all age groups (OR 1.05 in persons aged 50–59 years and OR 1.12 in those aged 60–69 years). Participation was also higher when no action was required to receive the FOBT kit, independently of the type of screening (Initial screening-first invitation [OR 2.24], Subsequent invitation for previous never-responders [OR 2.14], Subsequent invitation-regular [OR 2.03], Subsequent invitation-irregular intervals [OR 9.38]) and when quantitative rather than qualitative immunological FOBT (FIT) was offered (Initial screening-first invitation [OR 0.70], Subsequent invitation for previous never-responders [OR 0.12], Subsequent invitation-regular [OR 0.20]) or guaiac testing (Initial screening-first invitation [OR 0.81], Subsequent invitation for previous never-responders [OR 0.88], Subsequent invitation-regular [OR 0.73]). In conclusion, the results of this study show that screening participation could be enhanced by inclusion of the FOBT kit with the screening invitation and the use of the quantitative FIT.

Published
2017

17. Lesiones detectadas en seis programas poblacionales de cribado de cáncer colorrectal en España. Proyecto CRIBEA

Author

Portillo Villares, Isabel, Arana Arri, Eunate, Pérez Riquelme, Francisco, Vega Prieto, Mariola de la, Idígoras, Isabel, Espinàs, Josep Alfons, Oceja Setien, Elena, Ibáñez Cabanell, Josefa, Vanaclocha Espí, Mercedes, Salas Trejo, Dolores, González Aledo, Alvaro, Portillo Villares, Isabel, Arana Arri, Eunate, Pérez Riquelme, Francisco, Vega Prieto, Mariola de la, Idígoras, Isabel, Espinàs, Josep Alfons, Oceja Setien, Elena, Ibáñez Cabanell, Josefa, Vanaclocha Espí, Mercedes, Salas Trejo, Dolores, and González Aledo, Alvaro

Abstract

Background: In this study, the results of six Colorectal Cancer Screening Population Programmes are shown (Catalonia, Valence, Murcia, Cantabria, the Basque Country and the Canary Islands collected between 2005 and 2012. These programmes use the faeces occult blood test (FOBt) biennial. Objective: To determine and compare the results of lesions detected by the programmes, participation, sex, age and test used. Methods: Retrospective cohort study based on people invited, aged between 50-74 years, in at least a complete round. Lesions considered: Advanced Adenomas (AA), Colorectal Invasive Cancer (CRC) and both of them, known as Advanced Neoplasia (AN). Logistic Regression and time trends are used. Results: 1,995,719 of invitations registered, with an average participation-rate of 46.7%. 21,228 Advanced Neoplasias (2,813 CRC and 18,415 AA). Differences in detection rates observed between programmes (varying from 15.1‰ to 35.8‰ between participants). Participation rates were related to lesions’ detection rates (OR 1.25 in 40-60% of participation). . Inmunochemical qualitative test showed an OR of 4.79 and quantitative test an OR of 7.30 over the guaiac test. Men showed an OR of 2.73 with respect to women. In 2012 the Advanced Neoplasia rate for women and men was 33.1 and 14.2 by 1,000 participants. Conclusions: The test used was the most important factor for detecting lesions. Time trends showed an increase in detected lesions caused by the change of the type of test in 2010., RESUMEN Fundamentos: En este estudio se presentan los resultados de seis programas poblacionales de cribado de cáncer colorrectal desde 2005 a 2012 (Cataluña, Valencia, Murcia, Cantabria, País Vasco y Canarias) que utilizan diferentes tipos de test de cribado de sangre oculta en heces (SOH) bienal. El objetivo fue describir y comparar los resultados en cuanto a lesiones detectadas tanto por programa, participación, sexo, edad, tipo de test y comunidad autónoma. Metodos: Estudio de cohorte retrospectivo de las personas participantes en al menos una ronda completa cuya edad estaba comprendida entre los 50 y los 74 años. Lesiones consideradas: adenomas avanzados (AA), cáncer aolorrectal invasivo (CCR) y la suma de ambos, neoplasia avanzada (NA). Se realizó un nálisis de regresión logística y estudio de tendencias temporales. Resultados: Se obtuvieron 1.995.719 participaciones, lo que supuso el 46,7% de las invitaciones a participar. Se detectaron 21.228 neoplasias avanzadas (2.813 CCR y 18.415 AA). Se observaron diferencias en la detección de neoplasia avanzada (NA) entre los programas variando entre 15,1‰ y 35,8‰ participantes. La participación se relacionó con las tasas de detección (OR: 1,25 en 40-60% de participación). El test inmunoquímico cualitativo obtuvo una OR de 4,79 y el cuantitativo de 7,30 sobre guayaco. Los hombres tuvieron una OR de 2,73 sobre las mujeres, observándose en el 2012 una tasa de detección de neoplasia avanzada en hombres y mujeres de 33,1 y 14,2 x 1.000 respectivamente. Conclusiones: El tipo de test resultó el factor más determinante en la detección de lesiones. Las tendencias temporales mostraron un aumento de la tasa de detección por el cambio de test a partir del 2010.

Published
2017

22. Evaluación de dos estrategias de cribado de cáncer colorrectal: test inmunológico versus test bioquímico. Cataluña, 2008-2010

Author

García Martínez, Montse, Binefa, Gemma, Milà Díaz, Núria, Gonzalo Diego, Núria, Muñoz Sánchez, Carmen, Rodríguez Moranta, Francisco, Espinàs, Josep Alfons, Borràs, J. M., Moreno Aguado, Víctor, García Martínez, Montse, Binefa, Gemma, Milà Díaz, Núria, Gonzalo Diego, Núria, Muñoz Sánchez, Carmen, Rodríguez Moranta, Francisco, Espinàs, Josep Alfons, Borràs, J. M., and Moreno Aguado, Víctor

Abstract

Background: The aim of this study was to evaluate the screening strategy (quantitative immunological test vs biochemical test) in a population-based screening program for colorectal cancer (CRC) in Catalonia. Methods: The fourth round of a screening program for CRC with a fecal occult blood test was implemented in Hospitalet de Llobregat during 2008-2010. A biochemical test was offered to 50,227 individuals and a quantitative immunological test was offered to 12,707 individuals. We analysed differences according to the screening strategy in the following variables: acceptability of the target population (participation, dropouts, and adherence to colonoscopy), diagnostic accuracy (positive predictive value and detection rates), results (size and location of lesions, staging of CRC) and resources (number of colonoscopies needed and time interval between the positive test and colonoscopy). Results: Participation was higher among individuals who used the immunological test (OR: 1.35; CI95%:1.27-1.42). Detection rates for adenomas and cancer were also higher for the immunological test, hightlighting the detection rate for high-risk adenomas (26.7‰ vs. 3.0‰). The positive predictive value for high-risk adenomas was 45.0% and 46.9% in the immunological test and guaiac test, respectively. The number of colonoscopies needed to detect cancer with the immunological test was almost two-fold than those needed with the guaiac test (13.6 vs 7.4). Conclusions: The immunological test is a good screening strategy particularly sensitive for detecting high-risk adenomas. However, it is paramount to have enough resources to assure the quality of the CRC screening due to the large number of colonoscopies that would be required., Fundamento: El objetivo del estudio fue evaluar el cambio de estrategia de cribado (test inmunológico cuantitativo) en un programa poblacional de detección precoz de cáncer colorrectal (CCR) en Cataluña. Métodos: La cuarta ronda del programa de cribado de CCR en Hospitalet de Llobregat se implementó en 2008-2010. Se ofreció un test bioquímico a 50.227 individuos y uno inmunológico cuantitativo a 12.707 individuos. Se analizaron diferencias en las dos estrategias de cribado respecto a variables de aceptabilidad (entre participación, abandonos y adherencia a la colonoscopia), de precisión diagnóstica (valor predictivo positivo y tasas de detección), de resultados (tamaño y localización de lesiones, estadio de los cánceres detectados) y de recursos (número necesario de colonoscopias e intervalo de tiempo entre el resultado positivo del test y la colonoscopia). Resultados: La participación en el cribado fue superior entre los individuos que utilizaron el test inmunológico (OR: 1,35; IC95%:1,27-1,42). Las tasas de detección fueron superiores para el test inmunológico destacando la de adenomas de alto riesgo (26,7‰ vs 3,0‰). El valor predictivo positivo para adenomas de alto riesgo fue del 45,0% y del 46,9% en el inmunológico y el guayaco, respectivamente. El número de colonoscopias necesarias para detectar un cáncer fue de casi el doble que en el guayaco (13,6 vs 7,4). Conclusiones: El test inmunológico es una buena estrategia de cribado especialmente sensible para la detección de adenomas de alto riesgo. Sin embargo, requiere realizar un gran número de colonoscopias y por ello se debe disponer de los recursos y medios necesarios.

Published
2011

24. MLH1 promoter hypermethylation in the analytical algorithm of Lynch syndrome: a cost-effectiveness study

Author

Gausachs, Mireia, primary, Mur, Pilar, additional, Corral, Julieta, additional, Pineda, Marta, additional, González, Sara, additional, Benito, Llúcia, additional, Menéndez, Mireia, additional, Espinàs, Josep Alfons, additional, Brunet, Joan, additional, Iniesta, María Dolores, additional, Gruber, Stephen B, additional, Lázaro, Conxi, additional, Blanco, Ignacio, additional, and Capellá, Gabriel, additional

Published
2012
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26. Screening of cervical cancer in Catalonia 2006-2012.

Author

de Sanjosé, Silvia, Ibáñez, Raquel, Rodríguez-Salés, Vanesa, Peris, Mercè, Roura, Esther, Diaz, Mireia, Torné, Aureli, Costa, Dolors, Canet, Yolanda, Falguera, Gemma, Alejo, Maria, Espinàs, Josep Alfons, and Bosch, F. Xavier

Subjects
*CERVICAL cancer, *CANCER invasiveness, *PERIODIC health examinations, *PAPILLOMAVIRUSES
Abstract

The early detection of intraepithelial lesions of the cervix, through the periodic examination of cervical cells, has been fundamental for the prevention of invasive cervical cancer and its related mortality. In this report, we summarise the cervical cancer screening activities carried out in Catalonia, Spain, within the National Health System during 2008-2011. The study population covers over two million women resident in the area. The evaluation includes 758,690 cervical cytologies performed on a total of 595,868 women. The three-year coverage of cervical cytology among women aged between 25 and 65 years was 40.8%. About 50% of first screened women with negative results had not returned to the second screening round. The introduction of high-risk human papillomavirus DNA (HPV) detection, as a primary screening cotest with cytology among women over age 40 with a poor screening history, significantly improved the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+), being far superior to cytology alone. Cotesting did not improve the detection of CIN2+. The use of the HPV test for the triage of atypical squamous cell undetermined significance (ASC-US) improved the selection of women at high risk of CIN2+. Sampling (both cytology and HPV test) was largely performed by midwives (66.7%), followed by obstetricians (23.8%) and nurses (7%). Over half of the centres (54.8%) had full use of online medical records. During the study period, educational activities for professionals and for women were carried out periodically. The organisation of screening as a population activity in which women are actively called to the screening visit and the introduction of HPV testing as a primary screening tool are strongly recommended to ensure the maximum population impact in the reduction of the cervical cancer burden. [ABSTRACT FROM AUTHOR]

Published
2015
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