Screening-detected colorectal cancers show better long-term survival compared with stage-matched symptomatic cancers

Cienfuegos, Javier A.; Baixauli, Jorge; Ortega, Patricia Martínez; Valentí, Víctor; Regueira, Fernando Martínez; Martí‐Cruchaga, Pablo; Zozaya, Gabriel; Lizoáin, José Luis Hernández

doi:10.17235/reed.2018.5509/2018

Cited by 6 publications

(6 citation statements)

References 45 publications

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“…Cienfuegos et al also reported that symptom‐detected CRC patients had nearly a 3‐fold higher risk of death compared to screening‐detected CRC patients. Improved 5‐year survival in the group screened by colonoscopy was observed in patients with stage I (HR, 4.03; 95% CI, 1.24‐13.07) and III (HR, 2.14; 95% CI, 1.09‐4.19) cancer 21 . Those HRs were higher than that observed in our study, which may be related to the screening modality.…”

Section: Discussioncontrasting

confidence: 76%

Effect of colorectal cancer screening on long‐term survival of colorectal cancer patients: Results of the Korea National Cancer Screening Program

Luu

Lee

Jun

et al. 2022

Intl Journal of Cancer

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The Korea National Cancer Screening Program (KNCSP) provides fecal immunochemical test‐based colorectal cancer (CRC) screening for people aged ≥50 years. Our study aimed to investigate the long‐term survival effects of CRC screening based on screening history and interval time since screening. The study cohort was obtained by linking three national databases, namely the Korea Central Cancer Registry, KNCSP database and Death Certificate. We included 32 509 CRC patients diagnosed in 2008 to 2009, who underwent CRC screening via the KNCSP between 2004 and 2009. The patients were followed‐up until 2019, and their survival was assessed according to their CRC screening history. Cox proportional hazards regression was used to compare time to deaths among CRC patients according to CRC screening history, after adjusting for covariates. Of the 32 509 patients, 20 022 (61.5%) patients were alive by the end of 2019. Long‐term survival was significantly higher among screened patients (68.2%) than nonscreened (57.2%) individuals. Compared to never‐screened patients, the hazard ratio (HR) for CRC‐specific death in screened patients was 0.77 (95% CI%, 0.73‐0.80). Lowest HR was observed in screened, localized CRC patients (HR, 0.48; 95% CI, 0.42‐0.56); HR for CRC‐specific death was the lowest in patients screened within 12 months of diagnosis (HR, 0.70; 95% CI, 0.66‐0.74), following which, the HRs increased with increasing time interval. CRC screening was positively associated with favorable prognosis in CRC patients aged 50 to 79 years. The effects on long‐term survival according to interval time was the best among individuals screened within 1 year before diagnosis.

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Section: Discussioncontrasting

confidence: 76%

Effect of colorectal cancer screening on long‐term survival of colorectal cancer patients: Results of the Korea National Cancer Screening Program

Luu

Lee

Jun

et al. 2022

Intl Journal of Cancer

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“…This study revealed that, after adjusting for cancer stage and other variables, the mortality risks for colorectal cancer patients are ranked as follows: FIT-positive patients with follow-up examinations have the lowest risk, followed by FITpositive patients without follow-up, then FIT-negative patients, and finally, patients who were never screened have the highest risk. Unlike previous studies that compared prognoses between only two categories of patients-either screendetected versus symptomatically-diagnosed [11][12][13] or ever-screened versus never-screened 14 our research offers a more detailed stratification of patients' mortality risks. Specifically, we observed that patients who underwent screening, irrespective of their FIT results, consistently demonstrated lower mortality risks compared to those who were never screened.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have compared two types of colorectal cancer cases considering stage matching: the "screendetected" cases identified through screening methods and the "symptomatically diagnosed" cases detected based on the appearance of symptoms. [11][12][13] The research findings indicate that individuals who underwent colorectal cancer screening using methods such as colonoscopy or the traditional fecal occult blood testing (FOBT), also known as guaiacbased FOBT, showed significant survival advantages when diagnosed at more advanced stages. [11][12][13] However, discrepancies have arisen in their findings concerning early-stage colorectal cancer.…”

Section: Introductionmentioning

confidence: 99%

“…[11][12][13] The research findings indicate that individuals who underwent colorectal cancer screening using methods such as colonoscopy or the traditional fecal occult blood testing (FOBT), also known as guaiacbased FOBT, showed significant survival advantages when diagnosed at more advanced stages. [11][12][13] However, discrepancies have arisen in their findings concerning early-stage colorectal cancer. The limited sample sizes (less than 2500 patients) in these studies may account for the significant divergence in their outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Screening History and 7-Year Survival in 32,099 Colorectal Cancer Patients: A Population-Based Cohort Study

Hsiao,

Chiang,

Yang

et al. 2023

CLEP

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Background It is unclear whether colorectal cancer screening history, regardless of stage, is an independent predictor of survival, and if the screening advantage persists after diagnosis. 32 099 patients with colorectal cancer were enrolled in this population-based cohort study. Methods We used data from the Taiwan Cancer Registry on patients with a first-time diagnosis of colorectal cancer between 2013 and 2015. In addition, we utilized data from a nationwide database of colorectal cancer screening programs to evaluate patients’ screening histories, and sourced outcome data from the National Death Registry, tracking patients up to the last day of 2019. Results Compared with fecal immunochemical testing (FIT)-positive patients with a follow-up examination, the adjusted hazard ratios (95% confidence intervals) for death from colorectal cancer were 1.40 (1.26–1.56) for FIT-positive patients without a follow-up examination, 1.63 (1.48–1.78) for FIT-negative patients, and 1.76 (1.65–1.89) for never screened patients. The adjusted hazard ratios for the FIT-positive patients with a follow-up examination increased when diagnosis was delayed by more than 12 months and were 1.2 after a 2-year delay. The adjusted hazard ratios for FIT-negative patients were approximately 2.0, decreased rapidly to 1.6, and stabilized after the 9th time-to-diagnosis month. Conclusion In colorectal cancer patients, screening history prior to diagnosis is an independent prognostic factor, regardless of cancer stage or other variables. This study recommends that physicians take screening history into account during diagnosis to optimize follow-up and management for patients at higher risk.

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“…[4,32] However, overall survival at 48 months was 84.2%, higher than that reported in other studies. [4,33,34] As regards anatomic pathology, 98.27% of the tumours showed histology compatible with adenocarcinoma, and only one with lymphoma.…”

Section: Discussionmentioning

confidence: 99%

Colorectal Cancer Prevalence and Survival in Castilla La Mancha (Spain). A Pilot Study

González¹,

Ibáñez²,

Sotos³

2021

Preprint

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Background: Colorectal cancer is the most commonly diagnosed cancer type and the second cause of cancer death in Spain. The primary risk factor for colorectal cancer is age, with 90% of all diagnosed patients aged over 50 years. Prognosis mainly depends on tumour stage. Aim: Conduct a pilot Colorectal Cancer prevalence and survival study in Cuenca (Spain) since there are almost no studies based on small populations. This is the first pilot study about survival in screening of colorectal cancer carried out in hospitals in Castilla La Mancha. Methods and Results: Retrospective descriptive cohort study was performed to include patients with colorectal cancer diagnosed by colonoscopy between May 2015 and April 2016, and who were followed up for 48 months. The study considered sociodemographic and clinical data of the patients. Survival curves were estimated using the Kaplan-Meier method. The proportional hazard rate associated with age, gender, stage and presence of metastasis was calculated using the Cox regression method. 57 patients were included in the study. The mean follow-up was 45.5 months. Ten patients died during the study, in seven cases the cause was colorectal cancer. The percentage of patients alive at 48-month follow-up were 82.4%. Conclusion: Colon cancer is a high-prevalence pathology, with adenocarcinoma being the most common histology. The results seem to indicate that it affects men more frequently, mortality rises with tumour stage at diagnosis and declines with use of chemotherapy. We present a pilot study that could justify large-scale epidemiological studies for the regional surveillance and evolution of colorectal cancer in Spain.

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Screening-detected colorectal cancers show better long-term survival compared with stage-matched symptomatic cancers

Abstract: patients with stage I and III tumors that were diagnosed via a screening program have a higher overall and disease-free survival at five and ten years.

Cited by 6 publications

References 45 publications

Effect of colorectal cancer screening on long‐term survival of colorectal cancer patients: Results of the Korea National Cancer Screening Program

Effect of colorectal cancer screening on long‐term survival of colorectal cancer patients: Results of the Korea National Cancer Screening Program

Screening History and 7-Year Survival in 32,099 Colorectal Cancer Patients: A Population-Based Cohort Study

Colorectal Cancer Prevalence and Survival in Castilla La Mancha (Spain). A Pilot Study

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