Future Prospects of Colorectal Cancer Screening: Characterizing Interval Cancers

Ibáñez‐Sanz, Gemma; Sanz‐Pamplona, Rebeca; Garcia, Montse

doi:10.3390/cancers13061328

Cited by 8 publications

(14 citation statements)

References 99 publications

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“…There are two recent reviews that compare screen-detected versus FOBT interval cancer [ 9 , 24 ]. First, Wieten et al [ 24 ] published a systematic review and meta-analysis to evaluate the incidence rates of interval CRC following gFOBT and FIT in population-based CRC screening programmes.…”

Section: Discussionmentioning

confidence: 99%

“…They reported a lower incidence rate of interval cancer after a negative FIT than after the gFOBT (20 vs 34 interval CRCs per 100,000 person-years, respectively). Afterwards, our group performed a review [ 9 ] focused only in FIT-based population screening and found that the interval CRC proportion was around 15% and that interval cancers were more frequent in women and in the right colon and were staged more advanced. In this study, the findings are consistent with the literature as the interval cancer proportion was 45.3% for gFOBT and 17.7% for FIT.…”

Section: Discussionmentioning

confidence: 99%

“…The non-uptake cancers (those among individuals who decline the screening test and are later diagnosed with a CRC), interval cancers (a cancer detected after a negative FOBT and before the next invitation is due [ 8 ]) and screen-detected cancers. Interval cancers may either be due to a false-negative FOBT result or fast-growing (high microsatellite instability and CpG island methylator phenotype (CIMP)-high) [ 9 ] tumours that have developed between screening rounds. Consequently, the effectiveness of the program also depends on the ability of the screening test to detect cancers.…”

Section: Introductionmentioning

confidence: 99%

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Positive impact of a faecal-based screening programme on colorectal cancer mortality risk

et al. 2021

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Introduction The effectiveness of colorectal cancer (CRC) screening programs is directly related to participation and the number of interval CRCs. The objective was to analyse specific-mortality in a cohort of individuals invited to a CRC screening program according to type of CRC diagnosis (screen-detected cancers, interval cancers, and cancers among the non-uptake group). Material and methods Retrospective cohort that included invitees aged 50–69 years of a CRC screening program (target population of 85,000 people) in Catalonia (Spain) from 2000–2015 with mortality follow-up until 2020. A screen-detected CRC was a cancer diagnosed after a positive faecal occult blood test (guaiac or immunochemical); an interval cancer was a cancer diagnosed after a negative test result and before the next invitation to the program (≤24 months); a non-uptake cancer was a cancer in subjects who declined screening. Results A total of 624 people were diagnosed with CRC (n = 265 screen-detected, n = 103 interval cancers, n = 256 non-uptake). In the multivariate analysis, we observed a 74% increase in mortality rate in the group with interval CRC compared to screen-detected CRC adjusted for age, sex, location and stage (HR: 1.74%, 95% CI:1.08–2.82, P = 0.02). These differences were found even when we restricted for advanced-cancers participants. In the stratified analysis for type of faecal occult blood test, a lower mortality rate was only observed among FIT screen-detected CRCs. Conclusion CRC screening with the FIT was associated with a significant reduction in CRC mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Positive impact of a faecal-based screening programme on colorectal cancer mortality risk

et al. 2021

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“…Program invitations are distributed according to geographical areas, but these differences have been minimized by adjusting for an aggregated deprivation index. Finally, the number of CRCs cases was relatively small, although we included a large number of subjects, and the proportion of interval cancer was consistent with previous literature [ 32 ].…”

Section: Discussionmentioning

confidence: 84%

Diagnostic Performance of a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program According to Ambient Temperature and Humidity

Ibáñez‐Sanz

Milà

Vives

et al. 2022

Cancers

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Exposure of the fecal immunochemical test (FIT) to different ambient temperatures and humidity is unavoidable in population-based screening programs in Southern European countries, and it could lead to a decrease in target colorectal lesions. The objective was to evaluate the effect of ambient temperature and humidity on the FIT sensitivity in a population-based screening program for colorectal cancer (CRC) using an ecological design. The retrospective cohort included individuals aged 50–69 years who participated in CRC screening (Barcelona) from 2010–2015, and were followed until 2017 to identify interval CRCs. The positivity rate, and detection rates for advanced polyps and CRC were compared according to ambient temperature, humidity, and quarters of the year. A positive FIT was defined as the detection of ≥20 μg Hb/g in feces. The monthly ambient temperature and humidity were recorded on the day that the FIT was performed. In total, 92,273 FIT results from 53,860 participants were analyzed. The FIT positivity rate was lower at >24 °C than at ≤ 24 °C (p = 0.005) but was not affected by humidity. The temperature’s impact on positivity did not lead to a decrease in the FIT detection rate for advanced neoplasia or the interval cancer detection rate in a program where the samples were refrigerated until the analysis and screening invitations were discontinued in July and August.

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“…CRC is among the cancers with tremendous somatic mutations causing high heterogeneity ( 8 , 9 ). In 15% of CRCs, the high mutational burden (>12 mutations per megabase) is due to a defect in the genes of mismatch repair (MMR) systems such as MLH1, MSH2, MSH6, and PMS2, which causes transcriptional problems, especially in regions with repetitive nucleotides such as microsatellites.…”

Section: Introductionmentioning

confidence: 99%

Personalized Immunotherapy in Colorectal Cancers: Where Do We Stand?

Lan

Huang

et al. 2021

Front. Oncol.

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Colorectal cancer (CRC) is the second leading cause of cancer death in the world. Immunotherapy using monoclonal antibodies, immune-checkpoint inhibitors, adoptive cell therapy, and cancer vaccines has raised great hopes for treating poor prognosis metastatic CRCs that are resistant to the conventional therapies. However, high inter-tumor and intra-tumor heterogeneity hinder the success of immunotherapy in CRC. Patients with a similar tumor phenotype respond differently to the same immunotherapy regimen. Mutation-based classification, molecular subtyping, and immunoscoring of CRCs facilitated the multi-aspect grouping of CRC patients and improved immunotherapy. Personalized immunotherapy using tumor-specific neoantigens provides the opportunity to consider each patient as an independent group deserving of individualized immunotherapy. In the recent decade, the development of sequencing and multi-omics techniques has helped us classify patients more precisely. The expansion of such advanced techniques along with the neoantigen-based immunotherapy could herald a new era in treating heterogeneous tumors such as CRC. In this review article, we provided the latest findings in immunotherapy of CRC. We elaborated on the heterogeneity of CRC patients as a bottleneck of CRC immunotherapy and reviewed the latest advances in personalized immunotherapy to overcome CRC heterogeneity.

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Future Prospects of Colorectal Cancer Screening: Characterizing Interval Cancers

Cited by 8 publications

References 99 publications

Positive impact of a faecal-based screening programme on colorectal cancer mortality risk

Positive impact of a faecal-based screening programme on colorectal cancer mortality risk

Diagnostic Performance of a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program According to Ambient Temperature and Humidity

Personalized Immunotherapy in Colorectal Cancers: Where Do We Stand?

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