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Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test

Population screening has improved early diagnosis of colorectal cancer (CRC). Nonetheless, most cases are diagnosed in symptomatic patients. Faecal immunochemical testing has been recommended for assessing patients with lower gastrointestinal symptoms, but whether it improves patient survival is unk...

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Autores principales: Gutierrez-Stampa, María Angeles, Aguilar, Vanessa, Sarasqueta, Cristina, Cubiella, Joaquín, Portillo, Isabel, Bujanda, Luis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565457/
https://www.ncbi.nlm.nih.gov/pubmed/32854370
http://dx.doi.org/10.3390/cancers12092412
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author Gutierrez-Stampa, María Angeles
Aguilar, Vanessa
Sarasqueta, Cristina
Cubiella, Joaquín
Portillo, Isabel
Bujanda, Luis
author_facet Gutierrez-Stampa, María Angeles
Aguilar, Vanessa
Sarasqueta, Cristina
Cubiella, Joaquín
Portillo, Isabel
Bujanda, Luis
author_sort Gutierrez-Stampa, María Angeles
collection PubMed
description Population screening has improved early diagnosis of colorectal cancer (CRC). Nonetheless, most cases are diagnosed in symptomatic patients. Faecal immunochemical testing has been recommended for assessing patients with lower gastrointestinal symptoms, but whether it improves patient survival is unknown. Our objective was to compare CRC survival in 50- to 69-year-olds between asymptomatic screen-detected patients and symptomatic patients by route to diagnosis. Methods: We identified all cases of CRC diagnosed in 50-to 69-year-olds between 2009 and 2016, in Donostialdea (Gipuzkoa, Spain). Three groups were created: 1-screen-detected CRC; 2-CRC detected in symptomatic patients after a positive faecal immunochemical test(FIT); and 3-CRC detected in symptomatic patients without a FIT or after a negative result. We analysed survival using the Kaplan-Meier method and log-rank tests. Results: Of 930 patients diagnosed with CRC, 433 cases were detected through screening and 497 in symptomatic patients, 7.9% after a positive FIT and 45.5% by other means. The 3-year CRC survival was significantly lower in group 3 (69.5%) than groups 1 (93%; p = 0.007) or 2 (87.5%; p = 0.02). The risk of death was lower in groups 1 (HR 0.42, 95% CI 0.30–0.58) and 2 (HR 0.51; 95% CI 0.29–0.87). Conclusion: Half of CRC cases in 50- to 69-year-olds are diagnosed outside screening. Use of the FIT as a diagnostic strategy in symptomatic patients may improve survival.
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spelling pubmed-75654572020-10-26 Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test Gutierrez-Stampa, María Angeles Aguilar, Vanessa Sarasqueta, Cristina Cubiella, Joaquín Portillo, Isabel Bujanda, Luis Cancers (Basel) Article Population screening has improved early diagnosis of colorectal cancer (CRC). Nonetheless, most cases are diagnosed in symptomatic patients. Faecal immunochemical testing has been recommended for assessing patients with lower gastrointestinal symptoms, but whether it improves patient survival is unknown. Our objective was to compare CRC survival in 50- to 69-year-olds between asymptomatic screen-detected patients and symptomatic patients by route to diagnosis. Methods: We identified all cases of CRC diagnosed in 50-to 69-year-olds between 2009 and 2016, in Donostialdea (Gipuzkoa, Spain). Three groups were created: 1-screen-detected CRC; 2-CRC detected in symptomatic patients after a positive faecal immunochemical test(FIT); and 3-CRC detected in symptomatic patients without a FIT or after a negative result. We analysed survival using the Kaplan-Meier method and log-rank tests. Results: Of 930 patients diagnosed with CRC, 433 cases were detected through screening and 497 in symptomatic patients, 7.9% after a positive FIT and 45.5% by other means. The 3-year CRC survival was significantly lower in group 3 (69.5%) than groups 1 (93%; p = 0.007) or 2 (87.5%; p = 0.02). The risk of death was lower in groups 1 (HR 0.42, 95% CI 0.30–0.58) and 2 (HR 0.51; 95% CI 0.29–0.87). Conclusion: Half of CRC cases in 50- to 69-year-olds are diagnosed outside screening. Use of the FIT as a diagnostic strategy in symptomatic patients may improve survival. MDPI 2020-08-25 /pmc/articles/PMC7565457/ /pubmed/32854370 http://dx.doi.org/10.3390/cancers12092412 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gutierrez-Stampa, María Angeles
Aguilar, Vanessa
Sarasqueta, Cristina
Cubiella, Joaquín
Portillo, Isabel
Bujanda, Luis
Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test
title Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test
title_full Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test
title_fullStr Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test
title_full_unstemmed Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test
title_short Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test
title_sort colorectal cancer survival in 50- to 69-year-olds after introducing the faecal immunochemical test
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565457/
https://www.ncbi.nlm.nih.gov/pubmed/32854370
http://dx.doi.org/10.3390/cancers12092412
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