New Study Shows Stool Test and Colonoscopy Equally Effective in Colorectal Cancer Screening
A groundbreaking study conducted by researchers from Hospital ClínicIdibaps in Barcelona and the University Hospital of the Canary Islands has revealed that the stool occult blood test and colonoscopy are equally effective in the preventive detection of colorectal cancer. This significant research, published in the journal The Lancet, spanned ten years and involved a robust sample size of 57,000 individuals, demonstrating that both screening methods can effectively prevent colorectal cancer.
During the research, participants aged between 50 and 70 were randomly divided into two groups, consisting of both men and women. The clinical trial encompassed participants from eight autonomous communities: Aragón, Canarias, Cataluña, Galicia, Madrid, Murcia, País Vasco, and Comunidad Valenciana.
The study highlighted that citizen participation in screening was notably higher among the group opting for the stool occult blood test, with a participation rate of 40%, compared to only 32% for those undergoing colonoscopies. This disparity is primarily attributed to the invasiveness of the latter procedure. The research was led by Dr. Antoni Castells, medical director of Hospital Clínic in Barcelona and professor of gastroenterology at the University of Barcelona, alongside Dr. Enrique Quintero, a gastroenterologist at the University Hospital of the Canary Islands and professor at the University of La Laguna in Tenerife. The project, named Colonprev, was co-financed by the Spanish Association Against Cancer (AECC) and the Carlos III Health Institute, marking it as the first study worldwide to compare these two screening strategies.
According to Dr. Castells, the ten-year follow-up results illustrated that both colonoscopy and the stool occult blood test provide similar efficacy in detecting colorectal cancer, both significantly contributing to reduced mortality rates associated with the disease. After ten years, the study recorded a mortality rate of 0.22% in the colonoscopy group compared to 0.24% in the stool test group.
Dr. Quintero underscored the relevance of the study in advancing public health and urged higher citizen participation in preventive tests, noting that current participation remains below the European average of 45% and even lower at 50% in Catalonia.
In terms of costs, Dr. Castells pointed out the economic advantage of the stool occult blood test, which ranges between 2 to 4 euros versus the colonoscopy's cost of about 150 to 200 euros. Despite both tests being equally effective, the invasive nature of colonoscopies does pose certain risks.
The study also revealed interesting regional disparities, with participation rates noticeably higher in northern and eastern Spain and lower in the southern regions. These variations were attributed to the time elapsed since screening programs were initiated in these areas and the differences in the local systems that facilitate access to stool occult blood tests. For instance, local doctors provide the tests in the Basque Country, while pharmacies in Catalonia process samples from citizens.
Colorectal cancer, one of the most prevalent tumors and a leading cause of cancer mortality, can be prevented if identified early. It often develops from precancerous lesions known as polyps, which can progress to malignancy if not detected and removed in time.
The researchers emphasized the critical importance of early detection in preventing the disease or diagnosing it at its early stages. Early intervention not only enhances treatment efficacy but also increases the chances of a successful recovery. Given the results of this study, health institutions are urged to promote and incentivize participation in screening programs, which could ultimately save countless lives.
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