What happens with cancer screening participants with a positive faecal test that do not complete colonoscopy?
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Medical Resident of Preventive Medicine and Public Health, Spain
Colorectal Cancer Screening Program, Osakidetza, Spain
Biostatistics, OSI Barrualde Galdakao, Osakidetza, Spain
Euskadi´s Mortality Registry, Departamento de Salud, Spain
Bilbomatica SA, Spain
Preventive Medicine and Public Health, Osakidetza, Spain
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1427
Introduction: Colorectal cancer (CRC) was the second deadliest cancer for both sexes in 2020. The importance of having an effective CRC Screening Program is vital because it can reduce CRC´s burden of disease by decreasing its incidence and mortality. In the Basque Country, everyone betweeen 50 and 69 years old is biannually sent a Fecal Immunochemical Test (FIT) to their address and if it comes out positive is invited to book a colonoscopy. Colonoscopy its the gold standard test due tu its capacity to be a diagnostic and therapeutic test able to remove pre-cancerous lesions. A problem we must face is what to do when an indiviual cannot undergo a colonoscopy after a positive FIT test. Objective: Determine if there are differences in mortality rates bettween the different diagnostic pathways in Basque´s Country CRC Screening Program. Materials and methods: The study is a retrospective cohort of participants in the Screening Program  who have tested positive in FIT and after the have not completed a colonoscopy or have undergone another test. We received anonymized and untreaceble data from 922 participants. We made a decriptive analysis of the data and then we used Cox´s Regression and a Competitive risk´s model to evaluate global mortality and CRC´s sprecific mortality. Results: After statistical analysis we found significate differences in three variables. The first one is that people who cant undergo a colonoscopy have 3.47 times more risk of global mortality than people qho underwent an incomplete colonoscopy. The second one is that men in our cohort have 2.31 times more increased risk of global mortality than women and finally that age, regardless of sex, increses a 5% the mortality risk per increase of age unit.  
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