Initial Impact of National CRC Screening on Incidence and Advanced Colorectal Cancer.
Clin Gastroenterol Hepatol
; 21(3): 797-807.e3, 2023 Mar.
Article
em En
| MEDLINE
| ID: mdl-36116753
ABSTRACT
BACKGROUND AND AIMS:
Screening for colorectal cancer (CRC) aims to decrease CRC incidence and mortality. Biennial fecal immunochemical test screening started in the Netherlands in 2014 for individuals 55-75 years of age. This study investigated the effect of screening on stage-specific incidence, with focus on stage III and IV CRC.METHODS:
Inhabitants diagnosed with CRC in 2009-2018 were included. CRC incidence per stage, year, and detection method (ie, screen-detected vs clinically detected) was evaluated. Patient, tumor, and treatment characteristics, and survival of patients with stage III and IV CRC, were compared according to the detection method.RESULTS:
Included were 140,649 CRCs in 136,882 patients. An initial peak of stage I-III CRC diagnoses after initiation of screening was followed by a continuous decrease within screening-eligible ages. Total CRC incidence remained higher than before screening, although stage II and IV CRC incidence decreased below prescreening levels. Screen-detected CRCs were significantly more frequently located in the left-sided colon (stage III; 43.7% vs 30.9%; stage IV 45.1% vs 36.1%), and the primary tumor resection rate was higher (stage III colon 99.8% vs 99.0%, rectum 97.3% vs 89.7%; stage IV colon 65.4% vs 56.6%, rectum 47.3% vs 33.5%). Patients with screen-detected stage IV CRC had significantly more often single-organ metastases (74.5% vs 57.0%; P < .001) and more frequently received treatment with curative intent (colon 41.3% vs 27.4%; rectum 33.8% vs 24.6%). Overall survival significantly improved for patients with screen-detected CRCs (stage III P < .001; stage IV P < .001).CONCLUSIONS:
Five years after the start of a nationwide CRC screening program, a decrease in stage II and IV CRC incidence was observed. Patients with screen-detected stage III and stage IV CRC had less extensive disease and improved survival compared with those with clinically detected CRC.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Detecção Precoce de Câncer
Tipo de estudo:
Diagnostic_studies
/
Incidence_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article