Uptake patterns and predictors of colorectal cancer screening among adults resident in Spain: A population-based study from 2017 to 2020

Abstract

BackgroundAlthough population screening has improved the early diagnosis of colorectal cancer (CRC), most cases are diagnosed in symptomatic patients. This study aimed to estimate the prevalence and evolution over time of uptake patterns to fecal immunochemical test (FIT) as a screening test for CRC among individuals aged 50–69 in Spain, and to determine the predictive factors for uptake patterns to this type of screening based on sociodemographic, health, and lifestyle characteristics.MethodsA cross-sectional study with 14,163 individuals from the 2017 Spanish National Health Survey and the 2020 European Health Survey was performed, including as the main variable uptake pattern to FIT screening within the last 2 years, with which we analyzed sociodemographic factors, health status and lifestyle habits.Results38.01% of participants had undergone FIT in the previous 2 years, and from 2017 to 2020, a significant increase in the uptake rate for CRC was observed (2017: 32.35%, 2020: 43.92%, p < 0.001). The positive predictors to FIT uptake pattern included factors such as being between 57 and 69 years, having a higher educational level or a higher social class, having at least one chronic illness, frequent contact with the primary care physician, alcohol consumption and physical activity, while immigration and smoking habit were negative predictors.ConclusionIn Spain, although the evolution of FIT uptake pattern over time is positive, the prevalence of FIT uptake is still low (38.01%), not reaching the level considered as acceptable in the European guidelines. Moreover, there are disparities in CRC screening uptake among individuals.

Exploring the Influence of Social Class and Sex on Self-Reported Health: Insights from a Representative Population-Based Study

“…This strategic adjustment aligns with the flexibility endorsed by the Spanish Society of Epidemiology, which recognizes alternative groupings in social class categorization [35]. Moreover, our decision is reinforced by recent research within the same dataset, where the three-category approach was consistently utilized to characterize social class while investigating factors influencing screening test uptake for colorectal cancer [36]. Also, the consistency observed in contemporary epidemiological studies across diverse datasets in Spain further support our rationale [37,38].…”

Epidemiological Situation of High-Prevalence Non-Communicable Diseases in Spain: A Systematic Review

“…In addition to poor practice of good health habits, family history with CRC represented a core risk factor for developing the disease [32,34,36,44]. Similarly, Portero de la Cruz and Cebrino (2023) [67] found that socioeconomic status, level of education, social status and nationality were factors that intervened in the detection process. Also, a study conducted in a rural area demonstrated the needs for practitioners and the challenges that the population are faced with regarding the limitations of CRC screening [68].…”

“…These data are in agreement with a study conducted in Nebraska, where Gonzales et al (2023) [66] stated that CRC screening in conjunction with education are important points in the detection of the disease. Recently, a study in Spain concluded that the uptake of FIT (faecal immunochemical testing) between 2017 and 2020 increased, but the prevalence of FIT remains low compared to European guidelines [67].…”

Practice of colorectal cancer screening in the United Arab Emirates and factors associated – a cross-sectional study

“…This is higher than what was found in Saudi Arabia [ 8 ]. On the other hand, higher screening practices were found in Spain and the USA, with 38% and 80%, respectively [ 9 , 10 ] The vast difference in the rate of screening practice could be due to differences in healthcare policies influencing guidelines between these countries. National policies and guidelines can influence screening practices in the sense that countries that have implemented systematic screening programs and have policies supporting routine screening tend to have higher screening rates for CRC.…”