This project is funded by Minciencias (Colombia)
Background
Evidence has demonstrated the effectiveness of two-stage colorectal cancer (CRC) screening using fecal immunochemical testing (iFOBT), followed by colonoscopy in reducing the incidence and mortality of this disease. Colombia currently has an opportunistic screening program using mainly, guaiacol fecal occult blood test (gFOBT) which has a low sensitivity. In the last decade in Colombia the incidence and mortality by CRC increased
Objective
Design, implement and evaluate an organized screening program for colorectal cancer (CRC), using fecal immunochemical testing (iFBOT) and colonoscopy, in a region with high mortality risk in Colombia, promoting CRC prevention and generating an organizational culture of networking in this field, 2023-2026
Methodology
This study is a matched-pair, cluster-randomized community intervention trial. The Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) was used to matched clusters according to the following variables: population aged 50–75 years, average of inhabitants per health services, five-year mortality rate, five-year proportion of new reported cases, per-capita income, and educational level. Ten clusters comprising 20,020 individuals were included. Each matched pair consists in two municipalities; one assigned to the intervention (organized screening program) and the other to the control group (opportunistic program).
The primary outcome is the detection rate of premalignant colorectal cancer lesions through a screening program based on two-steps screening. As preliminary results, we describe sociodemographic variables and prevalence of risk factors among 7,124 participants. Baseline characteristics were compared between the control and intervention groups using the Pearson χ² test.
 
 
Results
Before intervention screening test has been practiced among symptomatic patients.
Preliminary results are presented for 5,264 participants in the control group and 1,860 participants in the intervention group. The mean and median age were 62 years in both groups (Table 1).Significant differences were observed in sex distribution (women, men, and others; p = 0.028), educational level, health-insurance affiliation, smoking exposure, alcohol consumption, and physical activity (all p < 0.001), indicating relevant sociodemographic and risk factors differences between groups.. Most participants were affiliated to the contributory health-insurance scheme followed by the state-subsidized. The proportion of ex-smokers is higher in the intervention group, 460 (25.0%). Monthly alcohol consumption is more common in the intervention group. Physical inactivity is prevalent, particularly in the intervention group; 61.9% reported no weekly physical activity.
The percentage of positive screening  results was 3.9% in the control arm and 2.7% in the intervention arm.
Conclusions/Implications.
The TOPSIS tool is employed is appropriate for achieving comparable groups in the design of a community intervention trial evaluating complex interventions, such as colorectal cancer screening.

Table 1. Sociodemographic characteristics and Risk factors