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

Sanne J K F Pluimers ¹, Pieter H A Wisse ¹, Monique E van Leerdam ²

⁰Department of Gastroenterology and Hepatology, Erasmus University Medical Center/Erasmus MC Cancer Institute, Rotterdam, the Netherlands.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association +

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September 26, 2024

View abstract on PubMed

Summary

Screen-detected colorectal cancer (CRC) shows significantly better disease-free survival (DFS) than non-screen-detected CRC. This improved DFS in screen-detected CRC is linked to a survival benefit, highlighting the importance of early detection.

Area Of Science

Oncology
Public Health
Cancer Screening

Background

Patients diagnosed with screen-detected colorectal cancer (CRC) exhibit superior stage-specific overall survival compared to those with non-screen-detected CRC.
It remains unclear whether differences in recurrence rates between screen-detected and non-screen-detected CRCs contribute to the observed survival disparities.

Purpose Of The Study

To evaluate and compare disease-free survival (DFS) rates between screen-detected and non-screen-detected colorectal cancer (CRC).
To determine if cancer recurrence influences overall survival in screen-detected versus non-screen-detected CRC cases.

Main Methods

Utilized data from the Netherlands Cancer Registry for Dutch CRC patients (stage I-III) diagnosed in the first half of 2015.
Employed Kaplan-Meier analysis for DFS and survival data, and Cox regression to assess the association between detection method, recurrence, and overall survival.

Main Results

Included 3725 CRC patients: 1652 (44.3%) screen-detected and 2073 (55.7%) non-screen-detected.
Screen-detected CRC demonstrated significantly higher 3-year DFS (87.8% vs 77.2%, P < .001).
Screening detection was independently associated with a reduced risk of recurrence (HR, 0.67; P < .001) and predicted improved overall survival.

Conclusions

Disease-free survival (DFS) is significantly better in screen-detected colorectal cancer (CRC) compared to non-screen-detected CRC, irrespective of other patient and tumor characteristics.
The improved DFS in screen-detected CRC is directly associated with a survival benefit, underscoring the value of cancer screening programs.

Keywords:

Colorectal Cancer Disease-Free Survival Mortality Recurrence Screening