Goodbye to colonoscopy? An alternative test is just as effective in detecting colon cancer.

BarcelonaCatalans between the ages of 50 and 69 always receive a letter at home or an SMS encouraging them to participate in colorectal cancer screening. The goal of this strategy is to detect the disease early. Although it has been proven that patient survival increases when treatment for this cancer begins in its earliest stages, less than half of those called in Catalonia participate in this program. Specifically, they are offered the option of undergoing a fecal occult blood test, a technique that is just as effective and much less invasive than colonoscopy in identifying cancer and reducing mortality. This is the conclusion of a study conducted by researchers from the Hospital Clínic de Barcelona-Idibaps and the University Hospital of the Canary Islands, published in the journal The Lancet this Friday.

This is a test that "achieves the same results in terms of mortality reduction and reduction of new cases of cancer compared to colonoscopy," explained the director of healthcare at the Clínic, Antoni Castells, during the presentation of the study's conclusions, with which they hope to improve the program's participation figures. For 10 years, researchers have followed 57,000 people per compare the effectiveness of the two main strategies for screening for colon and rectal cancer, which is the most common type of cancer in Spain. This is the first study to compare both techniques for detecting this type of cancer.

When Catalans receive the message to take the test, they are attached a list of pharmacies where they can pick up the test.kitto make the pot at home. The system is simple: you collect a stool sample with a stick, store it in a tube, and return it to one of the centers on the list for analysis. This will determine if there are signs that could cause cancer (precancerous lesions) or if a positive diagnosis has already been made. If the result is negative, it's important to participate every two years to also ensure that the tumor hasn't progressed.

Experts regret the low participation in screening, which they attribute to the fear of a positive diagnosis or the indication for a colonoscopy, which is an exam in which a probe with a camera is inserted to observe the interior of the large intestine and rectum to detect signs of cancer or other diseases. It is a safe and minimally invasive procedure, but it can cause discomfort to the person undergoing it or cause premature fear of the results. However, Castells emphasized that only 5% of all participants in early detection tests actually undergo a colonoscopy.

Increase participation

The researchers divided the participants into two groups. One group was invited to undergo a colonoscopy, while the other was offered the option of being tested every two years. The authors' primary objective was to compare colorectal cancer mortality after 10 years, which was found to be similar in both groups: 0.22% deaths in the colonoscopy group and 0.24% in the screening group. Where they did find differences was in participation, which was higher among those invited to undergo the fecal occult blood test. Specifically, 40% more than 32%.

However, according to Enrique Quintero, a gastroenterologist at the Hospital de Canarias and professor at the University of La Laguna in Tenerife, the number of participants remains "suboptimal" across the country as a whole, and he therefore calls for strengthening the strategy with the fecal occult blood test to improve current data. This test is also cheaper than colonoscopy, and researchers are now studying whether, beyond the cost, it also has greater benefits than colonoscopy in terms of effectiveness. However, Castells assured that the clinical guidelines will maintain both alternatives, as they are two "valid tools" for keeping colorectal cancer at bay.