15 years of the Colorrectal Cancer Screening Programme. Decreasing inequalities

Abstract Background The Colorectal Cancer (CRC) Screening Programme approved in 2008 by the Regional Parliament and carried out in 2009 a pilot study inviting to residents 50-69 years old (586,700), through a biennial Faecal Immunochemical Test (FIT), colonoscopy in FIT positive. The Programme Coordinating Centre sends FIT by post and involves Primary Care and Endoscopy departments in process and results control. In 2013, 100% coverage was reached, and in 2023 more than 80% were invited more than 6 times. However, inequalities in participation were detected: by age, gender, deprivation and vulnerability. Since 2014, different strategies have been carried out in order to decrease with the commitment of authorities, researchers and associations. Objectives To describe strategies and results to decrease inequalities in participation Results From the pilot participation rate increased (p < 0.001) 58.1% to 72.0% in 2023. Inequalities by gender (69.4 men vs 74.4% women) and deprivation index were detected (55.7/1000 lower vs high 41.0/1000). The non-adherence to colonoscopy was 5% along the period. Training, and communication campaigns developed. 2016-2017 special recruitment for imprisoned and mental health patients increasing participation rate (9.3 to 97.1%). In 2021 and ongoing: thanks to Resilience Funds (European Union), strategies were implemented: SMS specific by sex, research health literacy, studying CRC behavior by sex in FIT sensitivity 85.4% (CI95% 84.2-86.7) in men and 80.9% (CI95% (79. -82.6) in women p < 0.001 Conclusions The governance and involvement of professionals, researchers and patient associations crucial to decrease inequalities. The Basque Programme achieved one of the highest participation rate. Investment in reducing barriers will probably impact on the reduction of incidence and mortality. Key messages • A population based CRC Screening Programme reduces incidence and mortality on participants. • Intervention to increase participation reduces inequities and is crucial on Public Health policies.