title: [Lesions detected in a colorectal cancer screening program in the Basque Country: first round (2009-2011)].
abstract: Colorectal cancer (CRC) is a major public health problem due to its incidence and mortality. In May 2008, the Basque Country approved the implementation of a population-based colorectal cancer screening program, using the immunochemical fecal occult blood test (FOBT), in persons aged 50-69 years. Patients with a positive result were invited to undergo colonoscopy with sedation.
  
  
  OBJECTIVE
  To describe the main results of the first round of the CRC screening program with FOBT (2009-2011) in terms of the detection rates and positive predictive value (PPV).
  
  
  METHODS
  Retrospective study of participation rates and colonoscopic findings in persons with a positive FOBT result.
  
  
  RESULTS
  Invitations to attend screening were sent to 230.505 persons. A total of 148.249 FOBT tests were processed. The mean participation rate was 64.3% (95% CI: 64.1-64.5) and was higher in women than in men. The FOBT test was positive in 6.7% (95% CI: 6.6-6.8). Positive results were more frequent in men. Among persons with a positive result, colonoscopy was performed in 93.1%. There were significant differences between women and men in the detection rate of high-risk adenomas (OR: 0,45 95% CI 0,41-0,49), which, as with CRC (OR: 0,80 95% CI 0,66-0,96), were more frequent in men. The PPV for adenoma of any type was significantly higher in men (72.4 95% CI, 71.2-73.5) than in women (48.8% 95% CI 47.2-50.5), with differences by age group and type of adenoma.
  
  
  CONCLUSIONS
  Participation rates and detection of advanced lesions and CRC were high. Because men have a higher risk of developing CRC, efforts should be made to increase their participation. The impact of the CRC screening program should be evaluated in the medium to long term.
authors.affiliation: Centro Coordinador del Programa de Cribado Cáncer Colorrectal, Organización Central de Osakidetza-Servicio Vasco de Salud, España. Misabel.portillovillares@osakidetza.net
authors.forename: Isabel
authors.initials: I
authors.lastname: Portillo
authors.forename: Isabel
authors.initials: I
authors.lastname: Idígoras
authors.forename: Enrique
authors.initials: E
authors.lastname: Ojembarrena
authors.forename: Eunate
authors.initials: E
authors.lastname: Arana
authors.forename: Jose
authors.initials: J
authors.lastname: Luis Hurtado
authors.forename: Rosalba
authors.initials: R
authors.lastname: Basurko
authors.forename: Marian
authors.initials: M
authors.lastname: Tapia
authors.forename: Maria
authors.initials: M
authors.lastname: Luz Peña
mesh_terms: D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain; D013997:Time Factors