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Gastroenterology Research and Practice
Volume 2015, Article ID 672410, 9 pages
http://dx.doi.org/10.1155/2015/672410
Research Article

Interval Cancers in a Population-Based Screening Program for Colorectal Cancer in Catalonia, Spain

1Cancer Prevention and Control Program, Catalan Institute of Oncology, IDIBELL, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
2Barcelona Health Region, CatSalut, 08023 Barcelona, Spain
3Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), 28029 Madrid, Spain
4Department of Fundamental Care and Medical-Surgical Nursing, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
5Department of Clinical Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain

Received 9 December 2014; Revised 11 February 2015; Accepted 12 February 2015

Academic Editor: Bjørn Moum

Copyright © 2015 M. Garcia et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To analyze interval cancers among participants in a screening program for colorectal cancer (CRC) during four screening rounds. Methods. The study population consisted of participants of a fecal occult blood test-based screening program from February 2000 to September 2010, with a 30-month follow-up (n = 30,480). We used hospital administration data to identify CRC. An interval cancer was defined as an invasive cancer diagnosed within 30 months of a negative screening result and before the next recommended examination. Gender, age, stage, and site distribution of interval cancers were compared with those in the screen-detected group. Results. Within the study period, 97 tumors were screen-detected and 74 tumors were diagnosed after a negative screening. In addition, 17 CRC (18.3%) were found after an inconclusive result and 2 cases were diagnosed within the surveillance interval (2.1%). There was an increase of interval cancers over the four rounds (from 32.4% to 46.0%). When compared with screen-detected cancers, interval cancers were found predominantly in the rectum (OR: 3.66; 95% CI: 1.51–8.88) and at more advanced stages (). Conclusion. There are large numbers of cancer that are not detected through fecal occult blood test-based screening. The low sensitivity should be emphasized to ensure that individuals with symptoms are not falsely reassured.