Pilot program of Premature Diagnosis Colon and Rectum Cancer

Since 2000, the Institut Català d’Oncologia has been carrying out a program of premature diagnosis of Colon and Rectum Cancers. This program was created to respond to the objectives established in the Pla de Salut de Catalunya 1999-2001 where one could realize the importance of evaluating the acceptability and viability of a population program of colon and rectum cancer screening through a pilot test. The Pla de Salut de Catalunya 2002-2005 included, as an activity to be developed, the widening of the pilot test of premature diagnostic of colorectal cancer.
Carrying out the pilot screening test of colorectal cancer is also one of the priorities of acting in the fight against cancer established in the Pla Director d’Oncologia a Catalunya 2001-2004.
The results of the pilot tests will be the base of the decision of the Departament de Salut about the extension of the colorectal cancer screening to all Catalan population eventually.


Pilot Program of Premature Diagnostic of Colon and Rectum Cancer
The program is meant for men and women between 50 and 69 years old in the town of l’Hospitalet de Llobregat. The target population are invited by means of a personal letter to have detection test for hidden blood in faeces (PDSOF after the name in Catalan) completely free and voluntarily. If one wants to participate, s/he must send us back the pre-paid envelope with the participation application form. In a few weeks s/he will be sent the material to make the PDSOF at home, together with information on colon and rectum cancer and the instructions for the test.
The samples of faeces must be collected on 3 different days on the cardboard and post it inside the especial pre-paid envelope provided. The participants will receive the result by post at their homes within a few days. In some cases the test will have to be repeated to confirm the result; in others, a scan of the interior of the large intestine will be recommended.
If the person invited decides not to participate, s/he will be invited again after two years, as long as s/he stills coincides with the criteria of inclusion.

Impact of colon and rectum cancer in Catalonia
Colon and rectum cancer is a frequent illness from 50 years of age. It is the second most frequent cancer in women and the third in men. It is estimated that 4.000 new cases of colorectal cancer are diagnosed every year in Catalonia and 2.000 people die of it (it is the second cause of death by cancer both in men and in women). Most of the deaths of colorectal cancer (92%) happen to those older than 54.
The main factors of risk from the point of view of prevention are diet (rich in fat of animal origin and few vegetables) and physical exercise (sedentary life). The difficulty to change life stiles and the fact that the potentially beneficial effect is a long-term one poses the need to combine it with other strategies.
Screening is a possible strategy to make the impact of this illness diminish. The detection and elimination of the polyps, some of which could evolve into being malignant, prevents the illness from developing further. On the other hand, colorectal cancer detection and diagnostic at initial stages improve its previsions and the possibilities of healing and, at the same time, makes a less aggressive therapy and a better quality of life possible.
The importance of the impact of colorectal cancer on the population, as well as the scientific evidence existent about the screening, make it a priority to evaluate the viability of screening in Catalonia.