TY - JOUR
T1 - Oncologic outcomes of screen-detected and non-screen-detected T1 colorectal cancers
AU - Van Der Schee, Lisa
AU - Haasnoot, Krijn J.C.
AU - Elias, Sjoerd G.
AU - Gijsbers, Kim M.
AU - Alderlieste, Yasser A.
AU - Backes, Yara
AU - Van Berkel, Anne Marie
AU - Boersma, Femke
AU - Ter Borg, Frank
AU - Breekveldt, Emilie C.H.
AU - Kessels, Koen
AU - Koopman, Miriam
AU - Lansdorp-Vogelaar, Iris
AU - Van Leerdam, Monique E.
AU - Rasschaert, Gertjan
AU - Schreuder, Ramon Michel
AU - Schrauwen, Ruud W.M.
AU - Seerden, Tom C.J.
AU - Spanier, Marcel B.W.
AU - Terhaar Sive Droste, Jochim S.
AU - Toes-Zoutendijk, Esther
AU - Tuynman, Jurriaan B.
AU - Vink, Geraldine R.
AU - De Vos Tot Nederveen Cappel, Wouter H.
AU - Vleggaar, Frank P.
AU - Laclé, Miangela M.
AU - Moons, Leon M.G.
N1 - Publisher Copyright:
© 2024. The Author(s).
PY - 2024/7/1
Y1 - 2024/7/1
N2 - Background:The incidence of T1 colorectal cancer (CRC) has increased with the implementation of CRC screening programs. It is unknown whether the outcomes and risk models for T1 CRC based on non-screen-detected patients can be extrapolated to screen-detected T1 CRC. This study aimed to compare the stage distribution and oncologic outcomes of T1 CRC patients within and outside the screening program. Methods: Data from T1 CRC patients diagnosed between 2014 and 2017 were collected from 12 hospitals in the Netherlands. The presence of lymph node metastasis (LNM) at diagnosis was compared between screen-detected and non-screen-detected patients using multivariable logistic regression. Cox proportional hazard regression was used to analyze differences in the time to recurrence (TTR), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival. Additionally, the performance of conventional risk factors for LNM was evaluated across the groups. Results: 1803 patients were included (1114 [62%] screendetected), with median follow-up of 51 months (interquartile range 30). The proportion of LNM did not significantly differ between screen- and non-screen-detected patients (12.6% vs. 8.9%; odds ratio 1.41; 95%CI 0.89-2.23); a prediction model for LNM performed equally in both groups. The 3- and 5-year TTR, MFS, and CSS were similar for patients within and outside the screening program. However, overall survival was significantly longer in screen-detected T1 CRC patients (adjusted hazard ratio 0.51; 95%CI 0.38- 0.68). Conclusions: Screen-detected and non-screen-detected T1 CRCs have similar stage distributions and oncologic outcomes and can therefore be treated equally. However, screen-detected T1 CRC patients exhibit a lower rate of non-CRC-related mortality, resulting in longer overall survival.
AB - Background:The incidence of T1 colorectal cancer (CRC) has increased with the implementation of CRC screening programs. It is unknown whether the outcomes and risk models for T1 CRC based on non-screen-detected patients can be extrapolated to screen-detected T1 CRC. This study aimed to compare the stage distribution and oncologic outcomes of T1 CRC patients within and outside the screening program. Methods: Data from T1 CRC patients diagnosed between 2014 and 2017 were collected from 12 hospitals in the Netherlands. The presence of lymph node metastasis (LNM) at diagnosis was compared between screen-detected and non-screen-detected patients using multivariable logistic regression. Cox proportional hazard regression was used to analyze differences in the time to recurrence (TTR), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival. Additionally, the performance of conventional risk factors for LNM was evaluated across the groups. Results: 1803 patients were included (1114 [62%] screendetected), with median follow-up of 51 months (interquartile range 30). The proportion of LNM did not significantly differ between screen- and non-screen-detected patients (12.6% vs. 8.9%; odds ratio 1.41; 95%CI 0.89-2.23); a prediction model for LNM performed equally in both groups. The 3- and 5-year TTR, MFS, and CSS were similar for patients within and outside the screening program. However, overall survival was significantly longer in screen-detected T1 CRC patients (adjusted hazard ratio 0.51; 95%CI 0.38- 0.68). Conclusions: Screen-detected and non-screen-detected T1 CRCs have similar stage distributions and oncologic outcomes and can therefore be treated equally. However, screen-detected T1 CRC patients exhibit a lower rate of non-CRC-related mortality, resulting in longer overall survival.
UR - http://www.scopus.com/inward/record.url?scp=85184760645&partnerID=8YFLogxK
U2 - 10.1055/a-2263-2841
DO - 10.1055/a-2263-2841
M3 - Article
C2 - 38325403
AN - SCOPUS:85184760645
SN - 0013-726X
VL - 56
SP - 484
EP - 493
JO - Endoscopy
JF - Endoscopy
IS - 7
ER -
