Abstract
A cross-sectional study with 27,821 records of non-institutionalized people in Spain aged between 50–69 years old (59.94 ± 5.8 years), who participated in the European Health Survey in Spain (2009, 2014) and National Health Survey (2011/12, 2017). Fecal occult testing, the reason for performing the test, age, sex, nationality, social status, marital status, education level, body mass index (BMI), and place of residence. Overall, 54% were women, 93.9% were Spanish, 47.8% had a secondary study, and 66.4% were married. Across the years, the rate of the fecal occult blood test (FOBT) increased significantly (p < 0.001). This increase can be accounted for a letter campaign advising testing (45%, p < 0.001). FOBT was associated with more age (odds ratio—OR 1.04, 95% confidence interval—CI 1.04–1.05, p < 0.001), Spanish nationality (OR 1.91, 95% CI 1.25–2.93, p = 0.003), being married (OR 1.13, 95% CI 1.02–1.25, p = 0.025), having a higher level of education (OR 2.46, 95% CI 2.17–2.81, p < 0.001), belonging to high social classes (OR 1.35, 95% CI 1.12–1.64, p = 0.001), and BMI <25 (OR 1.72, 95% CI 1.25–2.37). Frequency of FOBT has increased in recent years. Performing FOBT is associated with age, nationality, marital status, higher education level, and social class.
Highlights
Worldwide, colorectal cancer (CRC) is the third most commonly diagnosed cancer in men and the second most common in women
A total of 27,821 records of people aged 50–69 years who participated in National Health Survey (NHS) 2011/12 and 2014; and European Health Survey in Spain (EHSS) 2009 and 2017 were analyzed
In Europe, CRC screening programs were first implemented in the year 2000, but their use has been dissimilar among the different countries
Summary
Colorectal cancer (CRC) is the third most commonly diagnosed cancer in men and the second most common in women. The incidence of CRC is greatest in developed countries [1–3]. The incidence of CRC has been increasing in Europe and Africa [2]. It is estimated that the incidence of CRC will increase by more than 60% by 2030 [4], possibly due to an increase in risk factors such as smoking, obesity, a non-healthy diet, and alcohol [4–6]. To prevent deaths from CRC, it is necessary to reduce the associated risk factors [6] and to develop policies for early detection [7,8]. The fecal occult blood test (FOBT) is recommended for CRC screening. The FOBT is popular because it is inexpensive and without risk [9]. If the FOBT is positive, a colonoscopy under sedation is performed. FOBTs are performed more than colonoscopies because the FOBT is a non-invasive test and does not cause pain [10,11]
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