Risk of Recurrence in Screen-Detected vs Non-Screen-Detected Colorectal Cancer Patients.

IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Clinical Gastroenterology and Hepatology Pub Date : 2024-09-24 DOI:10.1016/j.cgh.2024.08.033
Sanne J K F Pluimers, Pieter H A Wisse, Monique E van Leerdam, Evelien Dekker, Iris van Lansdorp-Vogelaar, Pieter J Tanis, Marloes A G Elferink, Caroline M den Hoed, Manon C W Spaander
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Abstract

Background and aims: Patients with screen-detected colorectal cancer (CRC) have a better stage-specific overall survival than non-screen-detected CRC. Currently, it is unknown if recurrence rates differ between screen-detected and non-screen-detected CRCs, and whether this could explain the observed difference in overall survival. Therefore, we aimed to assess the disease-free survival (DFS) rates in screen-detected and non-screen-detected CRCs and if recurrence affects overall survival.

Methods: Dutch CRC (stage I-III) patients, diagnosed by screening or not in the first 6 months of 2015, were included from the Netherlands Cancer Registry. DFS and survival data were retrieved and analyzed by Kaplan-Meier method. The association between mode of detection and recurrence and overall survival was evaluated with a Cox regression model.

Results: A total of 3725 CRC patients were included, 2073 (55.7%) non-screen detected and 1652 (44.3%) screen detected. Three-year DFS was significantly higher in screen-detected CRC compared with non-screen-detected CRC (87.8% vs 77.2%; P < .001). Stage-specific DFS rates for screen-detected vs non-screen-detected CRC were 94.7% vs 92.3% for stage I (P = .45), 84.3% vs 81.4% for stage II (P = .17), and 77.9% vs 66.7% for stage III (P < .001), respectively. Detection by screening was independently associated with a lower risk of recurrence (hazard ratio, 0.67; 95% confidence interval, 0.55-0.81; P < .001) when adjusted for age, sex, tumor location, stage and treatment. Recurrence independently predicted overall survival (hazard ratio, 15.90; 95% confidence interval, 13.28-19.04; P < .001).

Conclusion: DFS was significantly better in screen-detected compared with non-screen-detected CRCs independent of age, sex, tumor location, stage and treatment, and was associated with an overall survival benefit.

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筛查与非筛查发现的结直肠癌患者的复发风险。
背景和目的:筛查出的结直肠癌(CRC)患者的特定阶段总生存期优于未筛查出的 CRC。目前,筛查出的 CRC 和未筛查出的 CRC 的复发率是否存在差异,以及这是否能解释观察到的总生存率差异,尚不得而知。因此,我们旨在评估筛查出的和未筛查出的 CRC 的无病生存率(DFS),以及复发是否会影响总生存率:方法:我们从荷兰癌症登记处纳入了 2015 年上半年通过筛查或未通过筛查确诊的荷兰 CRC(I-III 期)患者。检索了DFS和生存数据,并采用卡普兰-梅耶尔法进行了分析。采用Cox回归模型评估了检测方式与复发和总生存率之间的关系:结果:共纳入 3725 例 CRC 患者,其中 2073 例(55.7%)为未筛查出的 CRC,1652 例(44.3%)为筛查出的 CRC。筛查出的 CRC 三年无病生存率明显高于未筛查出的 CRC(87.8% 对 77.2.%,pConclusion):筛查出的 CRC 与未筛查出的 CRC 相比,无病生存期明显更长,不受年龄、性别、肿瘤位置、分期和治疗方法的影响,并且与总生存期获益相关。
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来源期刊
CiteScore
16.90
自引率
4.80%
发文量
903
审稿时长
22 days
期刊介绍: Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.
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