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Interval colorectal cancer not more lethal than clinically detected disease
Patients with interval colorectal cancers have a similar risk for mortality as patients with clinically detected colorectal cancers, according to research published in Gastroenterology.
Henriette C. Jodal, MD, of the department of health management and health economics at the University of Oslo, in Norway, and colleagues wrote that their findings are contrary to the belief that cancers that develop rapidly between screenings are more lethal than clinically detected cancers. They saw the issue of interval cancers in surveillance methods with long periods between screening, like sigmoidoscopy, as an important area of study.
“As colorectal cancer screening becomes more widespread, optimal management of interval cancers will become an issue of increasing importance,” they wrote. “Indeed, if they are more lethal than colorectal cancers in general, a more aggressive initial treatment might be justified, but the evidence for this is currently lacking.”
Jodal and colleagues analyzed data from a randomized sigmoidoscopy trial comprising 98,684 patents who were randomly assigned to undergo (n = 20,552) or not undergo (n = 78,126) sigmoidoscopy and followed for a median of 14.8 years. They compared CRC mortality and all-cause mortality for patients that were diagnosed with CRC more than 30 days after screening (n = 163) with patients that were diagnosed with CRC in the non-screened group (n =1,740).
During the follow-up period, 43 patients in the interval cancer group died from CRC compared to 525 in the control group.
Investigators found no significant difference in CRC mortality (adjusted HR = 0.98; 95% CI, 0.72–1.35), rectosigmoid cancer mortality (aHR = 1.1; 95% CI, 0.63–1.92) and all-cause mortality (aHR = 0.99; 95% CI, 0.76–1.27) between both groups.
Jodal and colleagues wrote that their findings showed that patients diagnosed with interval CRC and patients with clinically detected CRC have a similar prognosis.
“This study shows that both colorectal cancer-specific and all-cause mortality of interval cancer after a normal sigmoidoscopy screen is similar to that of a clinically detected cancer in a non-screened control group,” they wrote. “It is therefore reasonable to assume that interval cancers are not more lethal than clinically detected cancer.” – by Alex Young
Disclosures: Jodal reports no relevant financial disclosures. Please see the full study for all other authors’ financial disclosures.