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Colorectal cancer-screening program improves both short- and long-term outcomes: a single-center experience in Trieste

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Abstract

Screening programs (SC) have been proven to reduce both incidence and mortality of CRC. We retrospectively analyzed patients who underwent surgical treatment for CRC between 01/2011 and 01/2017. The current screening program in our region collects patients aged from 50 to 69. For this reason, out of a total of 600 patients, we compared 125 patients with CRC founded during the SC to 162 patients who presented with symptoms and were diagnosed between 50–69 years old (NO-SC). 45% patients in the SC group were diagnosed as AJCC stage I vs 27% patients in the NO-SC group; 14% vs 20% were stage II, 14% vs 26% were stage III, and 3% vs 14% were stage IV (p 0.002). We found a significant difference in surgical approach: 89% SC vs 56% NO-SC patients had laparoscopic surgery (p 0.002). In the NO-SC group, 16% patients underwent resection in an emergency setting. Only 5% patients in the SC group had postoperative complications vs 14% patients in the NO-SC group (p 0.03). We had a 2-year OS of 86%, being 95% in the SC group and 80% in the NO-SC group (p 0.002). Likewise, the whole 2-year DFS was 77%, whereas it was 90% in the SC group and 66% in the NO-SC group (p 0.002). Screening significantly improves early diagnosis and accelerated surgical treatment. We obtained earlier stages at diagnosis, a less invasive surgical approach, and lower rates of complications and emergency surgery, all this leading to an improvement in both OS and DFS.

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Abbreviations

CRC:

Colorectal cancer

USPSTF:

US Preventive Services Task Force

FOBT:

Fecal occult blood test

FIT:

Fecal immunochemical test

CT:

Computed tomographic colonoscopy

gFOBT:

Guaiac fecal occult blood test

ASA score:

American Society of Anesthesiologists physical status classification score

AJCC:

American Joint Committee on Cancer

OS:

Overall survival

DFS:

Disease-free survival

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Acknowledgements

The authors thank all the General Surgery Unit Residents, Nurses, Surgeons and the entire staff for their cooperation.

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Author notes

  1. Pasquale Losurdo and Massimo Giacca have equal contributions.

Authors and Affiliations

  1. Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy

    Pasquale Losurdo, Massimo Giacca, Alan Biloslavo, Stefano Fracon, Elisabetta Sereni, Daniele Generali & Nicolo’ de Manzini

  2. Breast Unit Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS¸ Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy

    Fabiola Giudici

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  1. Pasquale Losurdo
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Contributions

All authors have contributed significantly to the paper and read and approved the manuscript. In particular, PL, MG, and NdM: conception and design of paper, final approval of the manuscript; FG, MG, and PL: analysis and interpretation of data; PL and MG: drafting of the manuscript; PL, MG, AB, SF, ES, FG, DG, and NdM: revising critically the manuscript for important intellectual content.

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Correspondence to Pasquale Losurdo.

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Conflict of interest

There is no conflict of interest for all authors regarding the publication of this manuscript and no financial issues to disclose.

Research involving human participants

The manuscript reports an observational retrospective study, so, on the basis of the resolution of the Authority for the Protection of Personal Data (Gazzetta Ufficiale N° 72—March 26, 2012—http://www.garanteprivacy.it/garante/doc.jsp?ID=1878276). This study has been conducted in accordance with the ethical standards of the Declaration of Helsinki. The institutional ethical board approved the study and the informed consent was obtained under the institutional review board policies of hospital administration.

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Informed consent was obtained from all individual participants included in the study. There are no relationships with industry.

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Losurdo, P., Giacca, M., Biloslavo, A. et al. Colorectal cancer-screening program improves both short- and long-term outcomes: a single-center experience in Trieste. Updates Surg 72, 89–96 (2020). https://doi.org/10.1007/s13304-020-00703-y

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