Factors Related to Non-participation in the Basque Country Colorectal Cancer Screening Programme.

Background: Despite the high participation rates in the Basque Country, colorectal cancer screening programme (Spain), there is still a part of the population that has never participated. Since it is essential to ensure equal access to health services, it is necessary to identify the determinants of health and socio-economic factors related to non-participation in the screening programme. Methods: Cross sectional descriptive study including all invited population in a complete round between 2015 and the first trimester of 2017. Health risk factors available in medical records and their control have been analyzed using univariate and multivariate analyses. Results: 515,388 people were invited at the programme with a 71.9% of fecal immunochemical test participation rate. Factors that increase the risk of non-participation are: being men (OR = 1.10, 95% CI 1.09-1.12); younger than 60 (OR = 1.18, 95% CI 1.17-1.20); smoker (OR = 1.20, 95% CI 1.18-1.22); hypertensive (OR = 1.14, 95% CI 1.12-1.15) and diabetic (OR = 1.40, 95% CI 1.36-1.43); having severe comorbidity (OR = 2.09, 95% CI 2.00-2.19) and very high deprivation (OR = 1.15, 95% CI 1.12-1.17), as well as making <6 appointments to Primary Care in 3 years (OR = 2.39, 95% CI 2.33-2.45). Still, the area under the curve (AUC) indicates that there are more factors related to non-participation. Conclusions: The participation in the Basque Country colorectal cancer-screening Programme is related to some risk factors controlled by Primary Care among others. Therefore, the involvement of these professionals could improve, not only the adherence to the CRC screening, but also other health styles and preventive interventions.

Evaluation of the colorectal cancer screening Programme in the Basque Country (Spain) and its effectiveness based on the Miscan-colon model.

The population-based Basque Colorectal Cancer (CRC) Screening Programme started in 2009 with a biennial immunochemical quantitative test (FIT) biennial and colonoscopy under sedation in positive cases. The population target of 586,700 residents was from 50 to 69 years old and the total coverage was reached at the beginning of 2014. The aim of our study was to determine possible scenarios in terms of incidence, mortality and reduction of Life-years-Lost (L-y-L) in the medium and long term of CRC. METHODS: Invitations were sent out by the Programme from 2009 to 2014, with combined organizational strategies. Simulation was done by MISCAN-colon (Microsimulation Screening Analysis) over 30 years comparing the results of screening vs no-screening, taking the population-based Cancer Registry into account. Lifetime population and real data from the Programme were used from 2008 to 2012. The model was run differentially for men and women. RESULTS: 924,416 invitations were sent out from 2009 to 2014. The average participation rate was 68.4%, CRC detection rate was 3.4% and the Advanced Adenoma detection rate was 24.0‰, with differences observed in sex and age. Future scenarios showed a higher decrease of incidence (17.2% vs 14.7%), mortality (28.1% vs 22.4%) and L-y-L (22.6% vs 18.4%) in men than women in 2030. CONCLUSIONS: The Basque Country CRC Programme results are aligned to its strategy and comparable to other programmes. MISCAN model was found to be a useful tool to predict the benefits of the programme in the future. The effectiveness of the Programme has not been formally established as case control studies are required to determine long term benefits from the screening strategy.

AIT en un paciente con enfermedad de Lyme: ¿causa o asociación accidental? / TIA in a patient with Lyme disease: cause or coincidental association?

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Prolactinoma in a sheep.

This report describes the incidental finding of an acidophilic adenoma of the pituitary gland in an adult ewe with clinical signs of a nervous disorder. Immunohistochemical examination demonstrated prolactin in the tumour cells, justifying the use of the term "prolactinoma" for the first time in veterinary medicine. This tumour should be considered in the differential diagnosis of nervous diseases of sheep.

Immunoreactivity to chromogranin and to vasoactive intestinal peptide in a canine phaeochromocytoma.

A canine phaeochromocytoma was diagnosed by (1) argyrophil methods, (2) immunoreactivity to chromogranin and to vasoactive intestinal peptide (VIP), and (3) the demonstration of typical electron-dense granules by transmission electron microscopy. This is the first report of immunoreactivity to general neuroendocrine markers such as chromogranin, and to VIP, in a phaeochromocytoma in domestic animals. The use of these markers for the differential diagnosis of phaeochromocytoma, and the role of VIP in the severe chronic diarrhoea shown by the dog in this study are discussed.

Pathological and epidemiological aspects of the coexistence of maedi-visna and sheep pulmonary adenomatosis.

Between 1982 and 1991, 159 sheep suffering from chronic respiratory disease were subjected to clinical, pathological, histopathological and serological examination. Maedi was diagnosed in 82 sheep and sheep pulmonary adenomatosis (SPA) in another 59. Forty-one of the latter (69.5 per cent) were seropositive for maedi-visna (MV) virus infection, but only six (10.2 per cent) showed concurrent lung lesions of maedi. Even disregarding the MV seronegative sheep and those younger than two years old, the rate of concurrent maedi lesions did not exceed 18 per cent. During a similar period, 5060 sheep from 161 flocks (86 of which also provided the 159 affected animals) were tested for antibodies to MV virus. The average seroprevalence of MV virus infection among flocks in which SPA was detected was 66.4 per cent, whereas in those in which SPA could not be demonstrated, and in those in which necropsies were not performed, the levels of MV virus infection were 55.1 per cent and 43.6 per cent, respectively. The effect of SPA on the seroprevalence of MV virus infection was independent of other factors, such as breed of sheep or the size of the flocks. These results provide evidence that SPA plays a role in the spread of MV virus infection, although a synergistic effect of the simultaneous infection on the expression of concurrent lesions does not seem to occur.