Colon cancer screening stagnates and Aragón looks for another plan

Ángel Lanas, head of the Digestive Service at the Zaragoza Clinical Hospital and scientific director of the IIS Aragón, speaks in El Periódico de Aragón about the colon cancer screening program in Aragón

Participation does not even reach 40% and Health is already in contact with several research institutes to establish a common scientific strategy. There is a latent lack of adherence to the project and experts believe that awareness "has decreased."

The colon cancer screening program in Aragon is stagnant. The project has been operating in public health since 2013 and throughout these years it is true that it has spread to the entire community, but the problem is the low response of the population. Participation in this early detection plan has not even reached 40% for several years - the latest data is even below 38% - and the situation forces us to rethink the strategy.

The Department of Health of the Government of Aragon is already in contact with several research institutes of the community to redesign the colon screening program. Specifically, conversations are being held with experts from the Aragon Health Research Institute (IIS), the Aragonese Institute of Health Sciences (IACS) and the Aragon Technological Institute (ITA) to find a common scientific strategy that allows « rethink” the initiative.

«The idea is to set a higher participation rate every two years because we detect that adherence to the program (continuity) is low. There are people who get tested but don't come back after two years. "There we have a serious problem," Ángel Lanas, head of the Digestive Service of the Clinical hospital de Zaragoza and scientific director of IIS Aragón.

«The participation of Aragonese in colon cancer screening barely reaches 45%»

The latest Health reports confirm a decreasing trend in colon screening. TOYes, in 2019 there was a participation of 54,11%, in 2020 42,52%, in 2021 39,90% and in 2022 37,6%. "Definitely, The pandemic hurt us a lot. “The screenings were paralyzed and it is being very difficult to regain a pulse.”, says Lanas. «I think that unconsciously there is still fear of going to the hospital and, in some way, it is as if the population has forgotten this screening and how important it is to participate in it. Awareness has decreased », she confesses.

For this expert, "at least" a participation of 60% would have to be achieved to consider that the plan works well. The target population to be screened in Aragon every two years is estimated at 366.508 men and women aged 50 to 69, of which not even 40% participate. «The optimal thing for the program to work and meet its objective would be to reach 70%. "It is something that is very far away from us, that is why we have to rethink the situation and we are already in talks," affects.

Fewer and fewer men

Another possible cause of the low participation that appears in Health reports is the fact that younger cohorts have entered screening - 50 to 55 years old. «There may be factors that make adherence to this screening lower. "The lesser follow-up to the program by men stands out," the documents indicate.

The early detection plan for colorectal cancer in Aragon was launched in December 2013 and was progressively extended from 2014 to all health sectors in Aragon. The test consists of performing a fecal occult blood test to detect cancer early. When the test is positive, the patient must undergo a colonoscopy for diagnostic confirmation and treatment if necessary. When the test is negative, the test is repeated after two years. This is when the disconnection between the population and this health resource is detected, because that adherence to the program in many cases disappears. “It is below expectations,” Lanas acknowledges.

Since its launch, in Aragon around 488.000 Aragonese in the 50 to 69 age group have been invited to participate in this screening and around 230.000 tests have been processed. "Most of them are negative," says the doctor. The most updated data corresponds to 2022, when of the 56.514 participants in the plan there were 3.383 Aragonese with a positive test (6,1% of participants).

The key: save lives

«In 83% of cases in which colon cancer is diagnosed, it is done in an early phase, in such a way that the patient does not require surgery or treatment. This is the great advantage and importance of participating in screenings. In the case of patients who do have symptoms, the proportion of complex patients with treatments is 50%," explains Lanas.

In addition to seeking a new scientific strategy to reactivate screening, it will also be necessary to reinforce dissemination and awareness campaigns. In this case, The Spanish Association Against Cancer in Aragon will be a great ally. «Until now, screening has worked by inertia. We always have to have a balance between demand and supply, because you cannot request many colonoscopies and harm, in some way, the hospital. It is a complex process, but we have to see a way to promote it more and reach more people," he says.

Lanas is clear about the three characteristics that define this early detection plan.. «On the one hand, it is accessible to everyone. On the other hand, it is a very easy test to do. And finally, it has been proven to save lives," he says bluntly.

Source: The newspaper of Aragon