Spolverato G, Capelli G, Battagello J, Barina A, Nordio S, Finotti E, Mondi I, Da Lio C, Morpurgo E, Navarro JA, Ceccato F, Perin A, Pedrazzani C, Turri G, Zanus G, Campi M, Massani M, Di Giacomo A, Prando D, Agresta F, Pucciarelli S, Zorzi M, Rugge M.

Front Oncol. 2021 Mar 15;11:620644. doi: 10.3389/fonc.2021.620644. eCollection 2021.


Background: Screening significantly reduces mortality from colorectal cancer (CRC). Screen detected (SD) tumors associate with better prognosis, even at later stage, compared to non-screen detected (NSD) tumors. We aimed to evaluate the association between diagnostic modality (SD vs. NSD) and short- and long-term outcomes of patients undergoing surgery for CRC.

Materials and methods: This retrospective cohort study involved patients aged 50-69 years, residing in Veneto, Italy, who underwent curative-intent surgery for CRC between 2006 and 2018. The clinical multi-institutional dataset was linked with the screening dataset in order to define diagnostic modality (SD vs. NSD). Short- and long-term outcomes were compared between the two groups.

Results: Of 1,360 patients included, 464 were SD (34.1%) and 896 NSD (65.9%). Patients with a SD CRC were more likely to have less comorbidities (p = 0.013), lower ASA score (p = 0.001), tumors located in the proximal colon (p = 0.0018) and earlier stage at diagnosis (p < 0.0001). NSD patients were found to have more aggressive disease at diagnosis, higher complication rate and higher readmission rate due to surgical complications (all p < 0.05). NSD patients had a significantly lower Disease Free Survival and Overall Survival (all p < 0.0001), even after adjusting by demographic, clinic-pathological, tumor, and treatment characteristics.

Conclusions: SD tumors were associated with better long-term outcomes, even after multiple adjustments. Our results confirm the advantages for the target population to participate in the screening programs and comply with their therapeutic pathways.

Keywords: colorectal cancer; colorectal cancer outcomes; disease free survival; overall survival; screening; surgery.

Copyright © 2021 Spolverato, Capelli, Battagello, Barina, Nordio, Finotti, Mondi, Da Lio, Morpurgo, Navarro, Ceccato, Perin, Pedrazzani, Turri, Zanus, Campi, Massani, Di Giacomo, Prando, Agresta, Pucciarelli, Zorzi and Rugge.

Pubmed https://pubmed.ncbi.nlm.nih.gov/33791207/