{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:24:04Z","timestamp":1787772244866,"version":"build-2784847793"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Organized screening programs using the fecal immunochemical test (FIT) have been implemented to reduce CRC mortality through early detection.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To evaluate the association between an organized FIT-based screening program and CRC-specific mortality in a population-based setting.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective, population-based cohort study included all residents of the Basque Country, Spain (approximately 2.2 million inhabitants) between 2004 and 2024. The FIT-based CRC screening program targeting individuals aged 50 to 69 years was initiated in 2009. Individuals aged less than 50 years were included in the study as a nonscreening reference group. Data analysis was performed in April 2026.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Biennial screening of asymptomatic individuals aged 50 to 69 years using single-sample FIT.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Age-standardized mortality rates (ASMRs) for CRC per 100 000 population (based on the European Standard Population 2013) and annual mortality trends from 2004 through 2024 were calculated. Segmented regression and counterfactual analyses estimated changes in CRC mortality after screening implementation. Screening participation, FIT positivity, colonoscopy adherence, CRC detection rates, and cancer stage distribution were also evaluated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 438\u202f134 total deaths (50.9% in men) in a population of approximately 2.2. million, 16\u202f298 (3.7%) were attributable to CRC. Age-standardized CRC mortality declined from 32.8 to 23.1 deaths per 100\u202f000 population between 2004 and 2024 (reduction of 29.6%;\n P<\/jats:italic>\n \u2009=\u2009.002). In individuals aged 50 to 69 years, CRC mortality declined by 50.1% (from 39.7 to 19.8 deaths per 100\u202f000 population). Segmented regression identified a significant inflection point in the year 2012 (95% CI, 2011-2014;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), 3 years after screening implementation. Counterfactual analyses estimated a 46.2% relative reduction in CRC mortality in the group aged 50 to 69 years compared with projected trends without screening. Among individuals aged 70 years or older, CRC mortality declined by 19.6% (from 165.4 to 132.9 deaths per 100\u202f000 population), corresponding to a 45.4% relative reduction compared with projected rates. Overall, 3464 of 4892 screen-detected CRCs (70.8%) were diagnosed at stage I or II throughout the study period.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this retrospective, population-based, descriptive cohort study, organized FIT-based screening was associated with a sustained decline in CRC mortality, particularly among individuals aged 50 to 69 years. These findings support the long-term benefit of organized FIT-based screening programs as a public health strategy to reduce CRC-related mortality.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.26951","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T15:00:40Z","timestamp":1785942040000},"page":"e2626951","source":"Crossref","is-referenced-by-count":2,"title":["Colorectal Cancer Mortality Following an Organized Fecal Immunochemical Test\u2013Based Screening Program"],"prefix":"10.1001","volume":"9","author":[{"given":"Luis","family":"Bujanda","sequence":"first","affiliation":[{"name":"Department of Liver and Gastrointestinal Diseases, Biogipuzkoa Health Research Institute\u2013Donostia University Hospital, University of the Basque Country (UPV\/EHU), Donostia\u2013San Sebasti\u00e1n, Spain"},{"name":"National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Val","sequence":"additional","affiliation":[{"name":"Department of Liver and Gastrointestinal Diseases, Biogipuzkoa Health Research Institute\u2013Donostia University Hospital, University of the Basque Country (UPV\/EHU), Donostia\u2013San Sebasti\u00e1n, Spain"},{"name":"National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Portillo Villares","sequence":"additional","affiliation":[{"name":"Basque Country Colorectal Cancer Screening Programme, Osakidetza, Basque Health Service, Biocruces Health Research Institute, Barakaldo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Idigoras-Rubio","sequence":"additional","affiliation":[{"name":"Basque Country Colorectal Cancer Screening Programme, Osakidetza, Basque Health Service, Biocruces Health Research Institute, Barakaldo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus M.","family":"Banales","sequence":"additional","affiliation":[{"name":"Department of Liver and Gastrointestinal Diseases, Biogipuzkoa Health Research Institute\u2013Donostia University Hospital, University of the Basque Country (UPV\/EHU), Donostia\u2013San Sebasti\u00e1n, Spain"},{"name":"National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain"},{"name":"IKERBASQUE, Basque Foundation for Science, Bilbao, Spain"},{"name":"Department of Biochemistry and Genetics, School of Sciences, University of Navarra, Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria A.","family":"Gutierrez-Stampa","sequence":"additional","affiliation":[{"name":"Altza Primary Care Health Center, OSI Donostialdea, Osakidetza, Basque Health Service, Donostia\u2013San Sebasti\u00e1n, Gipuzkoa, Spain"},{"name":"Primary Care Group, Biogipuzkoa Health Research Institute, Donostia\u2013San Sebasti\u00e1n, Gipuzkoa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arantza","family":"Lopez de Munain","sequence":"additional","affiliation":[{"name":"Departamento de Salud, Gobierno Vasco, Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Covadonga","family":"Audicana","sequence":"additional","affiliation":[{"name":"Departamento de Salud, Gobierno Vasco, Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Calleja","sequence":"additional","affiliation":[{"name":"Departamento de Salud, Gobierno Vasco, Vitoria-Gasteiz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaqu\u00edn","family":"Cubiella","sequence":"additional","affiliation":[{"name":"Research Group in Gastrointestinal Oncology Ourense, University Hospital of Ourense, Ourense, Spain"},{"name":"Department of Gastroenterology, University Hospital \u00c1lvaro Cunqueiro of Vigo, Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Izquierdo-Sanchez","sequence":"additional","affiliation":[{"name":"Department of Liver and Gastrointestinal Diseases, Biogipuzkoa Health Research Institute\u2013Donostia University Hospital, University of the Basque Country (UPV\/EHU), Donostia\u2013San Sebasti\u00e1n, Spain"},{"name":"National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"issue":"4","key":"zoi260745r1","first-page":"E499","article-title":"Global disparities in colorectal cancer: unveiling the present landscape of incidence and mortality rates, analyzing geographical variances, and assessing the 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cohort.","volume":"11","author":"van Wayenburg","year":"2000","journal-title":"Epidemiology"},{"key":"zoi260745r15","unstructured":"de Registros? S, Informaci\u00f3n? SGV. Mortalidad en la comunidad aut\u00f3noma de Euskadi 2024. Departamento de Salud. 2025. Accessed April 13, 2026. https:\/\/www.euskadi.eus\/contenidos\/informacion\/registros_mortalidad\/es_def\/adjuntos\/Informe-Mortalidad-2024.pdf"},{"key":"zoi260745r26","unstructured":"Irekia. La extensi\u00f3n del cribado de c\u00e1ncer colorrectal de Osakidetza a los 74 a\u00f1os detecta una tasa c\u00e1ncer que duplica en este tramo de edad a la del resto de poblaci\u00f3n cribada. March 30, 2026. 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