In 2015 32.197 new patients with colorectal cancer in Spain will be diagnosed and 16,000 deaths will result

– forecasts established by a study carried out in Aragon they indicate that after that date the incidence and mortality will continue to rise in males, with a more favorable behavior in women

– cost health total of colorectal cancer in Spain is estimated at more than 1.3 billion euros

-screening can reduce these costs by 40%

– 14.26% of the population aged between 50 and 69 years is involved in screening programs

A Spanish data from 2008 that encrypted in 28.551 new cases and 14.303 split the number of deaths from colorectal cancer; the international project Globocan, offers a mathematical projection for the future which foresees that by 2015 these figures increase to 32.197 new cases and deaths 16.104, according to be reference in an original work (1) published in the latest issue of the Spanish journal of digestive diseases (REED), organ of the Spanish society of digestive pathology (EDPS) scientific diffusion, whose first author is D.L. Bezerra de Sousa, who exhaustively complete these estimates until 2022 for the community autonomous of Aragón.

Madrid, January 2013.- in Spain, colorectal cancer is the third most common in males with an incidence rate of 39.7 cases and mortality of 18 cases per 100,000 inhabitants. In women, on the other hand, this type of cancer ranks second with an incidence of 23 cases and a mortality rate of 9.5 cases per 100,000 inhabitants.

this study in Aragón, projections are based on data from 1998 to 2007 and reveal that in men the prevalence would a rate of 237,2 to 273,7 cases per 100,000 inhabitants/year to compare data between 2007 and 2022. The incidence rate would rise from 48.2 to 55.2 cases and mortality from 22.7 to 26.0. Women, expected a reduction of the prevalence of 181,5 to 167,9 cases per 100,000 inhabitants/year of incidence rate that would decrease of 25.0 to 22 and mortality also descended from 11.3 to 10.3 cases per 100,000 inhabitants/year. In its conclusions the authors defend that these data suggest that it is necessary to plan measures for prevention and treatment more effective for this type of neoplasia.

programs for screening colorectal study points out that there are three causes that may relate to the decline in colorectal cancer mortality rates: changes in risk factors (obesity, reduced physical activity, and tobacco and alcohol consumption), screening programmes and improvements in treatments. According to Dr. Miguel Muñoz Navas, current President of EDPS and co-author in the same number of REED of a review article (2) on this topic, the greatest hope to reverse this situation is prevention and screening. Epidemiological data support the need to extend screening programmes throughout the Spanish territory, both to avoid the suffering of the people because they are cost effective and ”. In the same vein, the authors of the Aragonese study indicate that the detection of pre-cancerous lesions or early stage, through programs of screening, together with advances in surgical techniques and the adoption of treatment protocols must be measures used to reduce the mortality and incidence of cancer colorectal.

screening programmes are each most common time in developed countries through the detection of blood in stool and the colonoscopy test. It has been found that colonoscopy, after a positive fecal blood screening test, is some type of neoplasm in 70% of the subjects explored. In addition, as explained by Dr. Fernando Carballo, responsible for clinical excellence of EDPS, and co-author of the above-mentioned review, the effect of colonoscopy is double, because that sum diagnostic capability with direct treatment of malignant (adenomas) precursors and even carcinomas noninvasive with good prognosis ”.

in Spainthe first autonomous community to initiate an institutional program of screening was Catalonia in 2000. In the years 2005 – 2006 joined Valencia and the Region of Murcia, and in the years 2008 and 2009 Basque country, Cantabria and Canary Islands. La Rioja was added in the year 2010. Currently, Navarre, Aragon and Castile and León develop their programmes pilot.

treatment of colorectal cancer and screening costs knows also that the screening of the colon is highly cost-effective with a ratio around the 2,500 euros per quality-adjusted life year. The direct costs of cancer of colon and rectum in Spain is estimated at more than one billion euros. In Basque country, for example, has made an estimate of all costs attributable to its screening program and comes to the conclusion that every detected cancer costs 7.324,4 euros, each advanced adenoma 941,8 euros and screened everyone just 28.7 euros ”, explains Dr. Carballo. The program has diagnosed 3,874 people with high risk in the period 2009-2012, adenomas and estimating 20% of malignant transformation in this group, the savings achieved by avoiding the disease is 23.244.000 euros ”, concludes the expert. It is estimated that the cost medium in the first year of a detected in advanced-stage colorectal cancer is higher than the 30,000 euros, therefore early detection of 543 patients diagnosed with cancer in the same program and interval poses other 12.303.068 euros of savings. If both quantities are added total is 35.547.068 euros, for just over two years, and without that even the coverage has reached full population.

screening costs, although significant, are much smaller than the not diagnosed early colorectal cancer treatment, and avoided colorectal cancer costs by eliminating adenomas thanks to colonoscopy, is cost saved in cancer in the future. The spectacular ratio of cost effectiveness of screening programmes leaves no margin of doubt about the need to develop them in all the autonomous communities ” concludes Dr. Muñoz, in the same way the population understands and claiming breast cancer screening ”. The coverage of these programmes in Spain for the population of 50 – 69 years is currently of 14.26%.

Revista Española de diseases digestive (REED) La Revista Española de digestive diseases is the organ of expression of the EDPS, the AEED and the SEED. One of the oldest publications of speciality and greater impact Factor of the Hispanic field (current FI 1,548). the REED has a monthly and publishes, in Spanish and English, bilingual version quality work reviewed by pairs, which consist of original on clinical practice research and research in the area of Gastroenterology and hepatology, as well as in their technical related. Related topics include biochemistry, internal medicine, oncology and surgery digestive.

more information and access to the full text of the number in Spanish and English: www.reed.es

(1) estimates and projections of incidence, prevalence and mortality of colorectal cancer in AragónSpain, for the period from 1998 to 2020 ”. REV ESP ENFERM DIG. Vol. 104. No.10, pp. 518-523, 2012
(2) Prevent or cure in times of crisis: a propósito de colon cancer screening and straight ”. REV ESP ENFERM DIG. Vol. 104. No.10, pp. 537-545, 2012