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

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)