[Show abstract][Hide abstract] ABSTRACT: Background
News on health and health care are increasingly common in the mass media, and cancer is one of the most prominent topic among these news due to its health impact.Material and methodsAll news published in major newspapers in Catalonia, Spain between April to December 1996 were analysed, together with items from science and health supplements general information and science journals. Types of cancer-related topics, sources of information, the importance of cancer in the news item and the theme of the piece were analysed.ResultsDuring the period analysed, 974 news items were published which dealt with cancer. Of these, cancer was the principal topic in 53.5% of the items published in the national press, and 63.4% of the items published in the regional press. Cancer was the subject of an editorial comment on only four occasions. The source of information was mentioned in 64.8% of the items, and mean number of sources was 1.6. Political institutions were the most frequent source of information in newspapers, while science and health supplements and other magazines tended to cite scientific and health care institutions, as well as scientific journals. Basic research was the most common topic for news (30.3%) in science and health supplements while risk and environmental factors (29.6%) were the most common topics in magazines; environmental and technological risk factors (18,6%) and conflicts with health administrative bodies (16%) were the most frequent topics in the newspapers.Conclusion
News about risk factors and their prevention as well as technological and environmental factors related to cancer were among the most important topics published in the general press and magazines, together with conflicts with administrative bodies. Informations related to new therapies were a less frequent topic. Scientific journals have an important role as an information source for mass media together with political and scientific institutions.
[Show abstract][Hide abstract] ABSTRACT: to analyse the association between rectal bleeding or a family history of colorectal cancer (CRC) and the results obtained in two rounds of a CRC screening pilot programme performed in L Hospitalet, Barcelona, Spain.
males and females (50-69 years) were the target population. Together with the invitation letter, they received a questionnaire in which they were asked about rectal bleeding, family history of CRC and related neoplasms. The screening test was a guaiac-based faecal occult blood test (FOBT), and colonoscopy for positive tests.
25,829 FOBT were performed in 18,405 individuals. Information on rectal bleeding and a family history of CRC were obtained for 9,849 and 9,865 cases, respectively. Male sex (OR = 1.32), 60-69 years of age (OR = 1.48), rectal bleeding (OR = 1.84) and history of CRC (OR = 1.54) were independent predictors of positive FOBT. With regard to colonoscopy, a greater risk of diagnosing advanced neoplasm was observed among men (OR = 2.47) and subjects with a family history of CRC (OR = 1.98).
CRC screening programmes must have instruments that make it possible to select the candidate population and the possibility of offering a study suited to the risk of individuals who are not susceptible to population screening by means of FOBT.
No preview · Article · Dec 2009 · Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva
[Show abstract][Hide abstract] ABSTRACT: To assess the optimal cut-point for salivary cotinine concentration to identify smoking status in the adult population of Barcelona.
We performed a cross-sectional study of a representative sample (n=1,117) of the adult population (>16 years) in Barcelona (2004-2005). This study gathered information on active and passive smoking by means of a questionnaire and a saliva sample for cotinine determination. We analyzed sensitivity and specificity according to sex, age, smoking status (daily and occasional), and exposure to second-hand smoke at home. ROC curves and the area under the curve were calculated.
The prevalence of smokers (daily and occasional) was 27.8% (95% CI: 25.2-30.4%). The optimal cut-point to discriminate smoking status was 9.2 ng/ml (sensitivity=88.7% and specificity=89.0%). The area under the ROC curve was 0.952. The optimal cut-point was 12.2 ng/ml in men and 7.6 ng/ml in women. The optimal cut-point was higher at ages with a greater prevalence of smoking. Daily smokers had a higher cut-point than occasional smokers.
The optimal cut-point to discriminate smoking status in the adult population is 9.2 ng/ml, with sensitivities and specificities around 90%. The cut-point was higher in men and in younger people. The cut-point increases with higher prevalence of daily smokers.
No preview · Article · Jul 2009 · Gaceta Sanitaria
[Show abstract][Hide abstract] ABSTRACT: Colorectal cancer (CRC) screening effectiveness depends on the degree of implementation and population adherence. The goals of this study were to determine the number of CRC cases diagnosed in L'Hospitalet of Llobregat (Spain) and to identify the features of those cases detected by the population-based screening programme initiated in 2000 in this city.
Patients aged 50-69 year-old with a CRC diagnosis identified by cancer registries from the hospitals of L'Hospitalet were included. Patients were classified in 4 groups according to participation in the screening programme: 1, no participants; 2 diagnosed by screening; 3 participants with a negative screening result; and 4, participants with an incomplete screening process.
We found 510 patients diagnosed of CRC, 88% of whom had been invited to the screening programme. The distribution by tumour stage was: 0, 50 (9.8%); I, 53 (10.4%); II, 135 (26.5%); III, 154 (30.2%); IV, 105 (20.6%); and unknown, 13 (2.5%). The number of patients in each group was: 1, 350 (78.0%); 2, 58 (12.9%); 3, 29 (6.5%); and 4, 12 (2.7%). CRC detected by screening and by clinical diagnosis differed in some characteristics: cancer of colon (89.7% vs 66.2%, P<.001), symptoms (32.8% vs 84.3%, P<.001) and stages (0-II 75.9% vs 42.9%, III-IV 24.1% vs 54.2%, P<.001).
These results show the benefit of a population-based screening programme. CRC detected by the screening programme is diagnosed in early stages and before disease symptoms appear.
No preview · Article · May 2009 · Medicina Clínica
[Show abstract][Hide abstract] ABSTRACT: Background and objectiveColorectal cancer (CRC) screening effectiveness depends on the degree of implementation and population adherence. The goals of this study were to determine the number of CRC cases diagnosed in L’Hospitalet of Llobregat (Spain) and to identify the features of those cases detected by the population-based screening programme initiated in 2000 in this city.
No preview · Article · Apr 2009 · Medicina Clínica
[Show abstract][Hide abstract] ABSTRACT: Introducción
La baja sensibilidad de los test de sangre oculta en heces (TSOH) basados en el guayaco, ha hecho desarrollar nuevos tests inmunológicos con una eficacia para detectar neoplasia avanzada (adenoma avanzado y cáncer colorrectal) todavía no bien establecida.
Determinar la sensibilidad y especificidad de un TSOH basado en el guayaco (TSOHg) de alta sensibilidad con un TSOH inmunológico cuantitativo (TSOHi) para detectar neoplasia avanzada.
Material y métodos
Población: individuos con una colonoscopia programada por cualquier motivo (cribado, vigilancia o síntomas). Se excluyeron los individuos con enfermedad inflamatoria intestinal conocida y los pacientes con antecedentes de CCR intervenido. En los días previos a la exploración, se completaron 3 TSOHg (Hema-Screen) y 2 TSOHi (OC Senseor, test positivo ⩾100 ng/ml). Se calculó el tamaño de la muestra para demostrar la superioridad del TSOHi de un 15% de sensibilidad, con un tamaño final de 700 individuos.
Se evalúan los resultados de los primeros 140 individuos. Al 66% se les realizó la colonoscopia por síntomas y al resto por riesgo familiar o personal de CCR. La colonoscopia detectó 16 individuos (11%) con una neoplasia avanzada (2 carcinomas infiltrantes y 14 adenomas avanzados). El resto de lesiones encontradas fueron: 20 individuos con adenomas no avanzados, 11 con pólipos no adenomatosos y 4 colitis inflamatorias. La colonoscopia fue normal en 88 (63%) individuos.
El porcentaje de tests positivos fue de 3.5% (5/140) y 16,5% (23/140) para el TSOHg y TSOHi respectivamente. La sensibilidad, especificidad, VPP y VPN para detectar neoplasia avanzada fue de 12%, 97%, 40% y 89% para el TSOHg y de 62,5%, 89%, 60,8% y 81para el TSOHi. En caso de considerar únicamente el primer test inmunológico, la sensibilidad, especificidad, VPP y VPN fue de 43,7%, 92%, 43,7% y 92,7% respectivamente.
El TSOHi es muy superior al TSOHg para detectar neoplasia avanzada, aunque el elevado número de falsos positivos podría limitar su uso.
La utilización de uno o dos TSOHi debería evaluarse en función de los recursos endoscópicos disponibles.
No preview · Article · Mar 2009 · Gastroenterology
[Show abstract][Hide abstract] ABSTRACT: Background and aim: To describe colorectal cancer (CRC) mortality trends during 1985-2004 and to estimate CRC mortality projections for the period 2005-2019 in Spain.
Material and methods: A Bayesian age-period-cohort analysis has been carried out to investigate the effect of the age, period, and birth cohort on CRC mortality in Spain. Mortality projections until 2019 were based on the age-period-cohort model.
Results: During 1985-1994, CRC mortality increased in both sexes (3.9% yearly in men and 1.5% in women). After 1995, CRC mortality increased in men (1.6%) and leveled off in women (-0.6%). Colon cancer mortality increased for the whole period in men, this increase being lower in the second decade (1985-1994: 5.0%; 1995-2004: 1.8%). In women, colon cancer mortality increased in the first decade (2.8%) and leveled off during the second decade (-0.1%). Rectal cancer mortality increased in men (1.2%) and decreased in women (-1.1%) during the whole study period. Projections showed an increase in the number of CRC deaths in men older than 60 years and a level off in women.
Conclusion: Although mass screening for CRC in Spain has not been available, the favorable recent changes in CRC mortality trends observed after 1995 could be related to progress in diagnosis and treatment. The projected number of deaths could be used as reference scenario for assessing future impact of new treatments as well as the potential impact of future population-based screening when introduced.
Full-text · Article · Dec 2008 · European Journal of Gastroenterology & Hepatology
[Show abstract][Hide abstract] ABSTRACT: to evaluate lesions detected in two screening rounds performed in a pilot screening programme for colorectal cancer in Catalonia, Spain.
a colorectal cancer screening programme was initiated in 2000. The target population included men and women aged 50-69 years. Screening consisted of biennial guaiac-based fecal occult blood testing (FOBT), and colonoscopy for participants with a positive FOBT. Any polyps found were removed, and biopsies were performed for any masses.
colonoscopies were performed in 442 of 495 people with positive FOBT. In 213 (48.2%), 36 invasive cancers, 121 high-risk adenomas, 29 low-risk adenomas, and 27 hyperplastic polyps were diagnosed. Lesion size was smaller than 10 mm in 25.8% of cases. Most detected lesions (37.2%) were located in the distal colon, followed by the proximal colon (5.7%) and both locations (5.2%). Advanced neoplasm was significantly associated with male gender and distal location. The prevalence of advanced proximal neoplasms among patients with no distal polyps was 5.1%.
the most common lesions detected by colonoscopy were high-risk adenomas located in the distal colon. FOBT is a suitable method for detecting small precancer lesions during population screening, and is thus a key factor in reducing the incidence of colorectal cancer.
Full-text · Article · Jul 2008 · Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva
[Show abstract][Hide abstract] ABSTRACT: The study aimed to identify the extent of smoking, compliance with tobacco restrictions, and attitudes toward smoking and tobacco control measures among the employees in a Comprehensive Cancer Center from 2001 to 2006 where a smoke-free policy was progressively introduced. Four cross-sectional surveys were conducted from 2001 to 2006. Survey items include smoking status, smoking history, environmental tobacco exposure, and agreement with tobacco initiatives. The prevalence of smoking has declined from 34.5% in 2001 to 30.6% in 2006. The decrease was present in all professional groups: Doctors from 20.0% in 2001 to 15.2% in 2006 and administrative clerks from 56.0% in 2001 to 37.0% in 2006 reduced the most. Among nurses, the prevalence of smoking was still high with a 2-point percent reduction (from 34.0% in 2004 to 32.6% in 2006). Other changes of the pattern of smoking were apparent: a reduction on the number of cigarettes smoked, decrease of daily smokers, and increase of smoking abstinence during the hospital duty. Compliance with smoke-free areas increased. We observed a very significant decrease of the perception of exposure to environmental tobacco exposure at work. The Smoke Free project helped to achieve a healthy work environment. Tailored smoking cessation programs should be designed to help healthcare professionals to stop smoking. In addition, healthcare professionals should play a key role in promoting a healthy smoke-free lifestyle.
[Show abstract][Hide abstract] ABSTRACT: Ten years after the identification of the breast and ovarian cancer predisposition genes, BRCA1 and BRCA2, an emerging literature has explored the efficacy of strategies for primary as well as secondary prevention of breast and ovarian cancer in BRCA1 and BRCA2 mutations carriers. The integration of magnetic resonance imaging for breast cancer screening in BRCA carriers has achieved a higher sensibility of the screening, and an early detection of breast cancer. However, we don't have yet enough level of evidence that magnetic resonance imaging could reduce mortality in BRCA carriers. Because of the limitations of screening for ovarian cancer, bilateral prophylactic salpingo-oophorectomy has been established as one of the most effective strategies to prevent ovarian cancer in BRCA1 and BRCA2 mutation carriers. This strategy also has a favorable effect on the reduction of risk of breast cancer if is performed before the age of 50. The management of this patients must be individualized and multidisciplinary.
No preview · Article · Apr 2007 · Medicina Clínica
[Show abstract][Hide abstract] ABSTRACT: Ten years after the identification of the breast and ovarian cancer pre-disposition genes, BRCA1 and BRCA2, an emerging literature has explored the efficacy of strategies for primary as well as secondary prevention of breast and ovarian cancer in BRCA1 and BRCA2 mutations carriers.
The integration of magnetic resonance imaging for breast cancer screening in BRCA carriers has achieved a higher sensibility of the screening, and an early detection of breast cancer. However, we don’t have yet enough level of evidence that magnetic resonance imaging could reduce mortality in BRCA carriers.
Because of the limitations of screening for ovarian cancer, bilateral prophylactic salpingo-oophorectomy has been established as one of the most effective strategies to prevent ovarian cancer in BRCA1 and BRCA2 mutation carriers. This strategy also has a favorable effect on the reduction of risk of breast cancer if is performed before the age of 50. The management of this patients must be individualized and multidisciplinary.
[Show abstract][Hide abstract] ABSTRACT: To assess the feasibility of a colorectal cancer population-based screening programme in Catalonia (Spain).
A pilot colorectal cancer screening programme based on faecal occult blood (FOB) test was introduced in February 2000 in Hospitalet de Llobregat (Barcelona, Spain), a city of 239,000 inhabitants.
All the residents from the selected area, aged 50-69 years old, were invited by mail to participate in the screening programme. Overall, 63,880 persons were invited to the first screening round and 66,534, to the second round. Colonoscopy was the first choice of procedure for the positive FOB test.
The participation rate was 17.2% in the first screening round and 22.3% in the second round. The overall rate of positive FOBT was 3.4% in the first round and 0.8% in the second round. In the first round, the prevalence of screen-detected cancer was 2.1 per 1000 screened people, 7.2 for high-risk adenomas (HRA) and 11.3 for neoplasm (cancer and/or adenoma). The positive predictive value (PPV) was 6.2% for cancer, 21.2% for HRA and 33.3% for advanced neoplasm. In the second round, the prevalence of screen-detected cancer was 0.9 per 1000 people screened, 2.8 per 1000 for HRA and 4.2 per 1000 for neoplasm. The PPV was 10.6% for cancer, 34.1% for HRA and 50.4% for any neoplasm.
Regardless of the moderate participation rate, population-based colorectal cancer screening would be feasible in Catalonia, with good results in terms of prevalence of screen-detected neoplasms.
Full-text · Article · Feb 2007 · Journal of Medical Screening