This article is more than 5 years old. Information may no longer be current.
Diagnosis of colon cancer via screening colonoscopy improves surgery outcomes
Patients who underwent surgery to treat colon cancer had significantly better outcomes and a lower disease stage at presentation than patients diagnosed through other means in a recent study.
Researchers performed a retrospective review of 1,071 patients who underwent surgery for colon cancer between January 2004 and December 2011 at Massachusetts General Hospital. Two hundred seventeen patients were diagnosed via screening colonoscopy, and postoperative staging, survival and disease-free interval were compared between them and patients diagnosed using other methods.
“Screening colonoscopy is believed to be a major contributor to the consistent decline in the number of colorectal cancer diagnoses in the U.S. over the last decade,” the researchers wrote. “The current screening program … also contributes to earlier detection of malignant neoplasms, leading to significantly lower staging and perhaps better long-term outcome.”
The risk for a high-stage tumor was significantly greater among patients who were not diagnosed through screening colonoscopy (RR=1.96; 95% CI, 1.65-2.35 for T3 or higher). They also were at greater risk for nodal disease (RR=1.92; 95% CI,1.49-2.47) and metastatic disease at presentation (RR=3.37; 95% CI, 1.86-6.11). Risks for death (RR=3.02; 95% CI, 1.94-4.71) and recurrence (RR=2.19; 95% CI, 1.25-3.81) were elevated without a screening-based diagnosis, and both disease-free intervals (mean 109 weeks vs. 150 weeks; P<.001) and survival duration (mean 157.4 vs. 196.1 weeks; P<.001) were shorter in this group.
Multivariate analysis, adjusted for factors including age, BMI, N and T stages and metastatic presentation, indicated that patients diagnosed through screening colonoscopy continued to have longer survival (P=.01) and lower mortality rates (P=.02) than patients diagnosed via other means.
“Patients with colon cancer identified on screening colonoscopy are shown to have considerably better staging and outcomes than those with tumors identified through other means,” the researchers concluded. “Considering the tremendous effect early diagnosis through screening has for the prognosis of patients, this further emphasizes the important role compliance to screening colonoscopy guidelines can play in prolonging longevity, improving quality of life and reducing health care costs through early detection of colon cancer.”