Social inequalities in a population based colorectal cancer screening programme in the Basque Country

Background: While it is known that a variety of factors (biological, behavioural and interventional) play a major role in the health of individuals and populations, the importance of the role of social determinants is less clear. The effect of social inequality on population-based screening for colorectal cancer (CRC) could limit the value of such programmes. The present study aims to determine whether such inequalities exist. Methods: Data was obtained from the population-based screening programme administered in the Autonomous Community of the Basque Country, Spain, with a target population aged 50 to 69, first invited to participate between 2009 and 2011. The magnitude of inequality was analysed using the odds ratio (taking the least disadvantaged socioeconomic quintile as the reference population), the population attributable risk and the relative index of inequality, based on the regression, which is the ratio of the rates in the most and least disadvantaged socioeconomic groups. Results: The target population comprised 242,394 people, with the test kit successfully sent to 95.1 % (230,510). The overall response rate was 64.3 % (67.1 in women and 61.4 % men). Among women, the highest participation was in the third quintile (71.5 %) and the lowest in the first - the least disadvantaged (65.7 %). The lowest and highest rates of people with identified lesions were in the second and fourth quintiles (14.7/1000 and 17.0/1000 respectively). Among men, the response rate was lowest in the fifth - most disadvantaged - quintile (60.2 %). The highest rate of identified lesions was in the fifth quintile; 38 % higher than the first (55.7/1000 compared to 41.0/1000). Conclusions: Sex and socioeconomic group influence the rate of participation in the CRC programme and the rate of lesions found in the participants. Any public health programme is morally and ethically obliged to strive for equity and effectiveness. Improving participation of men and socially disadvantaged groups should be taken in account

Desigualdades sociales en la cobertura y participación en el Programa de Cribado de Cáncer Colorrectal de Euskadi.

276 p.Las diferentes modalidades de programas de cribado, así como la distribución desigual de los determinantes sociales de la salud, pueden generar desigualdades tanto en la cobertura como en la participación de los mismos. En Euskadi, se lleva a cabo el Programa de Cribado de Cáncer Colorrectal que, desde su inicio en 2009, ha ido aumentando su cobertura y participación. Continuar manteniendo la calidad del programa requiere la reducción de las desigualdades que en el mismo puedan existir. Objetivo: Comprobar la existencia de desigualdades de género, edad y socioeconómicas en la cobertura y participación en los programas de cribado de cáncer colorrectal y, en particular, en el Programa de Cribado de Cáncer Colorrectal de Euskadi. Métodos: el diseño del estudio ha estado basado en dos aproximaciones metodológicas: por una parte, se ha realizado una revisión sistemática de la literatura internacional sobre las desigualdades sociales en la participación en los programas de cribado de cáncer colorrectal. Por otro, se ha utilizado una aproximación cuantitativa utilizando datos relativos al Programa de Cribado de Cáncer Colorrectal de Euskadi, procedentes del registro del programa, para los años 2014-2015, así como derivados de las respuestas a las preguntas sobre el programa en la Encuesta Vasca de Salud de los años (ESCAV) 2013 y 2018. Resultados: los resultados de la revisión sistemática han mostrado la existencia de desigualdades sociales en la participación en los programas de cribado. El análisis, llevado a cabo con las dos muestras, ha obtenido evidencia de la existencia de desigualdades en la participación en el Test de Sangre Oculta en Heces (TSOH), que se ponen de manifiesto en relación con el género, la edad, el estado convivencial, la posición socioeconómica y la comorbilidad. ConclusiónEl Programa de Cribado de Cáncer Colorrectal de Euskadi está plenamente implantado y ha alcanzado un alto grado de calidad en sus más de diez años de implementación. Las diferentes acciones e intervenciones realizadas durante estos años han permitido actuar para reducir las desigualdades sociales que en el mismo se manifiestan, si bien no han logrado aún su desaparición

Urkidi-pagadi baten dinamika: Quercus-en dendrokronologia

En un estudio previo (Herrera, 2001) se reconstruyó la dinámica de un abedular-hayedo situado en el Parque Natural de Urkiola (Bizkaia). El presente trabajo estudia la dinámica del mismo bosque mediante el análisis de los anillos de crecimiento de roble pedunculado (Q. robur)y melojo (Q. pyrenaica).Todos los pies de ambas especies se instalaron a partir de 1950, en Q. pyrenaica el establecimiento máximo se dio en esta misma década mientras que en Q. robur fue posterior. Ambas especies presentaron una liberación del crecimiento en la decada de los 60.Aurretik buruturiko lan batean (Herrera, 2001) Urkiolako Parke Naturalean (Bizkaia) kokaturiko urkidi-pagadi dinamika berreiki zen. Lan honetan haritz kanduduna (Quercus robur)eta ametzaren (Quercus pyrenaica)urteroko hazkuntza-eraztunen analisiaren bitartez baso berdinaren dinamika aztertzen da. Bi espezieen oin guztiak 50. hamarkada ondoren ezarri dira, Q. pyrenaica-k maximoa hor izanik eta Q. robur-ek aldiz ondoren. Bien kasuan, hazkuntza askapena 60. hamarkadan gertatzen da.Un étude antérieur (Herrera, 2001) a reconstruit la dynamique d'un bois dominé par bouleaux et hêtres, au Parc Naturel d'Urkiola (Bizkaia). Ce nouveau travail analyse la dynamique du même bois, au moyen de l'étude des cernes de croissance de chêne pedonculé (Q. robur)et chêne tauzine (Q. Pyrenaica).Tous le pieds de deux chénes s'installairent après 1950; la plupart des tauzines s'installairent cette decade, cependant les pedonculés se sont installés plus tard. La croissance des deux chênes subit une liberation pendant la décade de 1960.A beech-birch forest located in the Urkiola Natural Park (Bizkaia) dynamics reconstruction was made and reported in a previous study (Herrera, 2001). Present work offers data about forest dynamics following ring-width chronologies of pedunculate oak (Quercus roburL.)and pyrenean oak (Q. pyrenaica). Sampled trees were established since 1950, while pyrenean oak shows a peak stablishment through this decade, pedunculate oak shows it later. Both tree species experienced a growth release in 1960 decade

Association between PhA and Physical Performance Variables in Cancer Patients

Maintaining the physical performance of cancer patients is increasingly considered due to the growing number of cancer patients and the aggressiveness of the treatments. For this reason, bioimpedance is now being used to record patients’ body composition by obtaining the phase angle (PhA). Although there is a direct relationship between PhA, age, sex and disease prognosis, it has not been measured as an analysis of physical performance in oncology patients and is a valid tool in the follow-up of cancer patients. For this purpose, 311 patients were evaluated, and both bioelectrical impedance analysis (BIA) and physical performance measurements were performed. The modification of the results concerning PhA was found to be highly relational, as a variation in one of the variables affected the other. It was concluded that each degree increase in PhA modified −22.57 s [−27.58; −17.53] in 400-m walking test (400 mWT); 13.25 kg [10.13; 16.35] in upper-body strength (UBS); 6.3 [4.95; 7.65] in lower-body strength (LBS); 1.55 mL/kg/min [0.98; 2.12] in VO2peak; 6.53 Watts [3.83; 9.20] in ventilatory threshold 1 (VT1); 10.36 Watts [7.02; 13.64] in ventilatory threshold 2 (VT2). It was also noted that age was a factor that affected the relationship between PhA and 400 mWT; the older the age, the higher the relationship. PhA data has been shown to be highly correlated with physical performance. This is of great importance in clinical practice because a cancer patient’s physical performance levels can be assessed during treatment

Short- and long-term effectiveness of a smartphone application for improving measures of adiposity: A randomised clinical trial – EVIDENT II study

[EN]Background: Evidence on the efficacy of smartphone applications (apps) for reducing body weight and other measurements of adiposity sustainably is not conclusive. Objective: To evaluate the effect of adding an app for 3 months to traditional counselling on physical activity (PA) and a heart-healthy diet for the modification of measurements of adiposity at 3 and 12 months after intervention. Methods: This randomised clinical trial included 833 subjects. The counselling and app group (IG) had 415 subjects, while 418 were included in the counselling only group (CG). The primary outcome was adiposity measurements at 3 and 12 months after intervention. The secondary outcome was the effect of the intervention by sex. Intervention: Counselling on a heart-healthy diet and PA was given to both groups. The IG also received training in the use of a smartphone app designed to promote a heart-healthy diet and PA, and this group was given access to this application for 3 months. Outcome measurements included waist circumference (WC), body mass index (BMI) and Clínica Universidad de Navarra – body adiposity estimator (CUN-BAE). Results: In the IG at 12 months, the following decreased: WC −0.72 cm (95% confidence interval [CI]: −2.35 to −0.02) and CUN-BAE −0.35 (95% CI: −0.63 to −0.06). These decreases were only observed in women. After baseline adjustment, the beneficial effect was maintained in the IG compared to the CG at 12 months in terms of WC (−0.67; 95% CI: −0.29 to −0.02) and CUNBAE (−0.57; 95% CI: −1.10 to −0.04), but only in women. Conclusions: An intervention of nutritional counselling and PA plus the smartphone app with personalised recommendations compared to CG showed beneficial results in terms of reduction of abdominal obesity and the percentage of body fat in women, but not in men.This study was funded by the Spanish Ministry of Science and Innovation (MICINN), the Carlos III Health Institute/European Regional Development Fund (ERDF) (MICINN, ISCIII/FEDER) (FIS: PI13/00618, PI13/01526, PI13/00058, PI13/01635, PI13/02528, PI12/01474; RETICS: RD12/0005, RD16/0007, RD12/0005/0001) and the Regional Health Management of Castilla and León (GRS 1191/B/15, GRS 909/B/14, GRS 770/B/13)