Plain English Summary
Background and study aims
The impact of colorectal cancer population screening strategies on mortality outside of randomized controlled trials remains unknown. The objective of this study was to measure the mid-term impact of the introduction of colorectal cancer screening programmes on colorectal cancer mortality rates across Spain.
Who can participate?
The entire population of Spain
What does the study involve?
The research team review the number of deaths by colon cancer by reviewing Spanish Statistical Office data of mortality recorded in a database every 6 months for the 17-year study period. Information about the screening implementation and uptake is also observed using from regional registries.
What are the possible benefits and risks of participating?
There are no direct benefits or risks incolved with participating
Where is the study run from?
Hospital Clínic de Barcelona (Spain)
When is the study starting and how long is it expected to run for?
January 2019 to February 2019.
Who is funding the study?
Investigator-initiated and funded.
Who is the main contact?
Impact of population screening on colorectal cancer mortality: a natural experiment
1. Has the implementation of colorectal cancer screening in Spanish provinces that adopted it been effective in reducing colorectal cancer mortality?
2. Has the implementation of colorectal cancer screening in Spanish provinces had a differential effect by gender?
Approved 19/02/2019 Ethics Committee, Hospital Clínic de Barcelona (Villarroel, 170, 08036 Barcelona, Spain; +34 93 227 57 66; email@example.com), ref HCB/2018/0109.
Observational natural experiment
Primary study design
Secondary study design
Patient information sheet
No participant information sheet available.
The present study is an ecological analysis of colorectal cancer-specific deaths at a province level. We compare age-standardised mortality rates in provinces that were exposed to screening with provinces that did not.
The individual's data comes from the Spanish Statistical Office, and only includes death certificate data combined with population census data at a province level. The data was obtained through the INE
Primary outcome measure
Current primary outcome measure as of 25/02/2019:
Mortality rates will be measured using the biannual CRC-specific 1999 age-standardised mortality rates (measured by the National Statistical Office of Spain) for the population aged 50-69 years old.
Previous primary outcome measure:
Mortality rates will be measured using the biannual CRC-specific 1999 age-standardised mortality rates (measured by the National Statistical Office of Spain) for the population aged 50-79 years old.
Secondary outcome measures
1. Biannual CRC-specific 1999 Age-standardised mortality rates for overall population, measured by the National Statistical Office of Spain (INE)
2. Biannual CRC-specific 1999 Age-standardised mortality rates for population aged between 40 to 49 years old, measured by the National Statistical Office of Spain (INE)
3. Biannual CRC-specific 1999 Age-standardised mortality rates for population aged between 0 to 39 years old, measured by the National Statistical Office of Spain (INE)
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
The entire population of Spain
Target number of participants
The entire population of Spain: 46000000
Participant exclusion criteria
Resident of Spanish provinces that started screening after 2009.
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Hospital Clínic de Barcelona
Pompeu Fabra University
C/ Ramón Trias-Fargas 25-27
Investigator initiated and funded
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Planned publication of findings as an academic paper in a high-ranking, open access medical journal. After publication, a press release will be created that is accessible to all with assistance from the Pompeu Fabra University external communications team. Results will also be presented at national and international public health conferences.
IPD sharing statement: due to compliance with the Spanish Statistical Office regulation, data will not be available at the end of the study, but can be accessed through: https://www.ine.es/welcome.shtml.
Intention to publish date
Participant level data
Not expected to be available
Basic results (scientific)