title: Participation and detection rates by age and sex for colonoscopy versus fecal immunochemical testing in colorectal cancer screening.
abstract: OBJECTIVE
  To compare two strategies for colorectal cancer screening: one-time colonoscopy versus fecal immunochemical testing (FIT) (and colonoscopy for positive) every 2 years, in order to determine which strategy provides the highest participation and detection rates in groups of sex and age.
  
  
  METHODS
  This analysis was performed with data from the first screening round within the COLONPREV study, a population-based, multicenter, nationwide trial carried out in Spain. Several logistic regression models were applied to identify the influence of the screening test on participation rates and detection of proximal and distal neoplasms, as well to identify the influence of age and sex: women aged 50-59 years, women aged 60-69 years, men aged 50-59 years, and men aged 60-69 years.
  
  
  RESULTS
  Participation was higher in women than in men, especially among women aged 50-59 years (25.91 % for colonoscopy and 35.81 % for FIT). Crossover from colonoscopy to FIT was higher among women than men, especially among those aged 60-69 years (30.37 %). In general, detection of any neoplasm and advanced adenoma was higher with colonoscopy than with FIT, but no significant differences were found between the two strategies for colorectal cancer detection. Detection of advanced adenoma in both arms was lower in women [specifically in women aged 50-59 years (OR 0.31; 95 % CI 0.25-0.38) than in men aged 60-69 years]. Women aged 50-59 years in the colonoscopy arm had a higher probability of detection of advanced adenoma (OR 4.49; 95 % CI 3.18-6.35), as well as of detection of neoplasms in proximal and distal locations (proximal OR 19.34; 95 % CI 12.07-31.00; distal OR 11.04; 95 % CI 8.13-15.01) than women of the same age in the FIT arm. These differences were also observed in the remaining groups but to a lesser extent.
  
  
  CONCLUSIONS
  Women were more likely to participate in a FIT-based strategy, especially those aged 50-59 years. The likelihood of detection of any neoplasm was higher in the colonoscopy arm for all the population groups studied, especially in women aged 50-59 years. Distinct population groups should be informed of the benefits of each screening strategy so that they may take informed decisions.
authors.affiliation: General Directorate Public Health, Avda. Calatuña, 21, 46020, Valencia, Spain, salas_dol@gva.es.
authors.forename: Dolores
authors.initials: D
authors.lastname: Salas
authors.forename: Mercedes
authors.initials: M
authors.lastname: Vanaclocha
authors.forename: Josefa
authors.initials: J
authors.lastname: Ibáñez
authors.forename: Ana
authors.initials: A
authors.lastname: Molina-Barceló
authors.forename: Vicente
authors.initials: V
authors.lastname: Hernández
authors.forename: Joaquín
authors.initials: J
authors.lastname: Cubiella
authors.forename: Raquel
authors.initials: R
authors.lastname: Zubizarreta
authors.forename: Montserrat
authors.initials: M
authors.lastname: Andreu
authors.forename: Cristina
authors.initials: C
authors.lastname: Hernández
authors.forename: Francisco
authors.initials: F
authors.lastname: Pérez-Riquelme
authors.forename: José
authors.initials: J
authors.lastname: Cruzado
authors.forename: Fernando
authors.initials: F
authors.lastname: Carballo
authors.forename: Luis
authors.initials: L
authors.lastname: Bujanda
authors.forename: Cristina
authors.initials: C
authors.lastname: Sarasqueta
authors.forename: Isabel
authors.initials: I
authors.lastname: Portillo
authors.forename: Mariola
authors.initials: M
authors.lastname: de la Vega-Prieto
authors.forename: Juan Diego
authors.initials: JD
authors.lastname: Morillas
authors.forename: Vicente
authors.initials: V
authors.lastname: Valentín
authors.forename: Angel
authors.initials: A
authors.lastname: Lanas
authors.forename: Enrique
authors.initials: E
authors.lastname: Quintero
authors.forename: Antoni
authors.initials: A
authors.lastname: Castells
mesh_terms: D000367:Age Factors; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012737:Sex Factors