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Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
Published on: June 8, 2020
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Screening or Symptoms? How Do We Detect Colorectal Cancer in an Equal Access Health Care System?
Quinton M Hatch1, Kevin R Kniery2, Eric K Johnson2
1Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA, 98431, USA. qhatch@gmail.com.
Summary
Early colorectal cancer detection is crucial. Despite equal access, symptomatic diagnosis remains common, but fecal occult blood testing (FOBT) significantly predicts early-stage diagnosis.
Area of Science:
- Oncology
- Gastroenterology
- Public Health
Background:
- Colorectal cancer (CRC) screening aims for early detection.
- Military healthcare systems provide equal access to screening.
- Understanding diagnostic modalities and their impact on CRC stage is essential.
Purpose of the Study:
- To analyze CRC diagnosis methods in an equal access military population.
- To evaluate the correlation between TNM stage and diagnostic modality (screening vs. symptomatic).
Main Methods:
- Retrospective chart review of 197 newly diagnosed CRC patients (2007-2014).
- Evaluation of TNM stage based on screen detection (FOBT, sigmoidoscopy, CT colonography, colonoscopy) or symptomatic evaluation.
- Statistical analysis of diagnostic modality and cancer stage.
Main Results:
- 25% of CRC cases were detected via screening; 75% were symptomatic.
- Screening detected predominantly early-stage disease (I-II).
- Fecal occult blood testing (FOBT) independently predicted early-stage diagnosis (Stage I-II) (OR 8.7).
Conclusions:
- Symptomatic diagnosis of CRC remains more prevalent than screen detection, even with equal access.
- Fecal occult blood testing (FOBT) is a valuable tool for early CRC detection.
- Future initiatives should focus on enhancing FOBT-based screening for CRC.
