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The Effectiveness of Screening Total Colonoscopy for Preoperative Patients with Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Colorectal cancer (CRC) is the most common cancer that coincides with gastric cancer (GC). Although the usefulness of total colonoscopy (TCS) as a CRC screening tool has been reported in preoperative patients with GC, the long-term outcome of patients with synchronous CRC (SCRC) remains unclear. This study aims to clarify the significance of preoperative screening TCS for GC in terms of survival outcomes.

Patients and Methods

We included 796 patients who underwent preoperative screening TCS for GC. The risk factors, clinicopathological features, and survival outcome of SCRC were examined. Furthermore, the cost-effectiveness was evaluated from the perspective of improving the rates of mortality caused by CRC.

Results

SCRC was observed in 43 patients (5.4%). Endoscopic treatment for SCRC was performed on 30 patients. In total, 15 patients underwent surgical resection, including 2 patients requiring additional surgery after endoscopic treatment. Regarding pathological stages, 25 patients had stage 0, 12 patients had stage I, 5 patients had stage II, and 1 patient had stage IIIB disease. The cumulative mortality rates were as follows: GC-related deaths, 12.6%; deaths from cancers other than CRC, 1%; deaths from other causes, 5.5%. No deaths were attributed to SCRC. Comparing the patients who did not undergo TCS, an incremental cost-effectiveness ratio analysis suggested that a screening cost of 5.86 million yen was required to prevent one CRC death.

Conclusions

Curative treatment was possible in all patients with SCRC. No deaths were attributed to SCRC, suggesting that screening TCS for GC is effective.

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References

  1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49.

    Article  PubMed  Google Scholar 

  2. Arnold M, Sierra MS, Laversanne M, et al. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66:683–91.

    Article  PubMed  Google Scholar 

  3. Balakrishnan M, George R, Sharma A, et al. Changing trends in stomach cancer throughout the world. Curr Gastroenterol Rep. 2017;19:36.

    Article  PubMed  PubMed Central  Google Scholar 

  4. US Preventive Services Task Force, Davidson KW, Barry MJ, et al. Screening for colorectal cancer: US preventive services task force recommendation statement. JAMA. 2021;325:1965–77.

    Article  Google Scholar 

  5. Rex DK, Boland CR, Dominitz JA, et al. Colorectal cancer screening: recommendations for physicians and patients from the US multi-society task force on colorectal cancer. Am J Gastroenterol. 2017;112:1016–30.

    Article  PubMed  Google Scholar 

  6. Kato T, Suzuki K, Muto Y, et al. Multiple primary malignancies involving primary sporadic colorectal cancer in Japan: incidence of gastric cancer with colorectal cancer patients may be higher than previously recognized. World J Surg Oncol. 2015;13:23.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Takeuchi D, Koide N, Suzuki A, et al. High incidence of other primary malignancies in patients with synchronous multiple gastric cancers “a multi-center retrospective cohort study.” Oncotarget. 2018;9:20605–16.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Imai K, Hotta K, Yamaguchi Y, et al. Clinical impact of colonoscopy for patients with early gastric cancer treated by endoscopic submucosal dissection: A matched case-control study. Dig Liver Dis. 2017;49:207–12.

    Article  PubMed  Google Scholar 

  9. Saito S, Hosoya Y, Togashi K, et al. Prevalence of synchronous colorectal neoplasms detected by colonoscopy in patients with gastric cancer. Surg Today. 2008;38:20–5.

    Article  PubMed  Google Scholar 

  10. Kim HO, Hwang SI, Yoo CH, Kim H. Preoperative colonoscopy for patients with gastric adenocarcinoma. J Gastroenterol Hepatol. 2009;24:1740–4.

    Article  PubMed  Google Scholar 

  11. Yoo HM, Gweon TG, Seo HS, et al. Role of preoperative colonoscopy in patients with gastric cancer: a case control study of the prevalence of coexisting colorectal neoplasms. Ann Surg Oncol. 2013;20:1614–22.

    Article  PubMed  Google Scholar 

  12. Ojima T, Iwahashi M, Nakamori M, et al. Is preoperative colonoscopy necessary for patients undergoing gastric cancer surgery? Ann Surg Oncol. 2014;21(Suppl 3):S379–84.

    Article  PubMed  Google Scholar 

  13. Ito Y, Miwa T, Kanda M, et al. Risk score for predicting death from other causes after curative gastrectomy for gastric cancer. Gastric Cancer. 2023;26:317–23.

    Article  CAS  PubMed  Google Scholar 

  14. Zauber AG, Winawer SJ, O’Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366:687–96.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Hashiguchi Y, Muro K, Saito Y, et al. Japanese society for cancer of the colon and rectum. Japanese society for cancer of the colon and rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol. 2020;25:1–42.

    Article  PubMed  Google Scholar 

  16. Ajani JA, In H, Sano T, et al. In: Stomach MB Amin, eds. AJCC Cancer Staging Mannual, Eight Edition. New York: Springer-Verlag, 2016.

  17. Japanese Society for Cancer of the Colon and Rectum. Japanese classification of colorectal, appendiceal, and anal carcinoma: the 3d English Edition [Secondary Publication]. J Anus Rectum Colon. 2019;3:175–95.

    Article  PubMed Central  Google Scholar 

  18. Japanese Gastric Cancer Association. Japanese classification of Gastric Carcinoma, Third English Edition. Japan: Gastric Cancer, 2011.

  19. Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013;48:452–8.

    Article  CAS  PubMed  Google Scholar 

  20. Tanaka K, Sobue T, Zha L, et al. Effectiveness of screening using fecal occult blood testing and colonoscopy on the risk of colorectal cancer: the Japan public health center-based prospective study. J Epidemiol. 2023;33:91–100.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kodashima S, Tanaka K, Matsuda K, et al. First progress report on the Japan endoscopy database project. Dig Endosc. 2018;30:20–8.

    Article  PubMed  Google Scholar 

  22. Brenner H, Stock C, Hoffmeister M. Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies. BMJ. 2014;348:g2467.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Vermeer NC, Snijders HS, Holman FA, et al. Colorectal cancer screening: systematic review of screen-related morbidity and mortality. Cancer Treat Rev. 2017;54:87–98.

    Article  CAS  PubMed  Google Scholar 

  24. Saito H, Kudo SE, Takahashi N, et al. Efficacy of screening using annual fecal immunochemical test alone versus combined with one-time colonoscopy in reducing colorectal cancer mortality: the Akita Japan population-based colonoscopy screening trial (Akita pop-colon trial). Int J Colorectal Dis. 2020;35:933–9.

    Article  PubMed  Google Scholar 

  25. Dominitz JA, Robertson DJ, Ahnen DJ, et al. Colonoscopy vs. fecal immunochemical test in reducing mortality from colorectal cancer (CONFIRM): rationale for study design. Am J Gastroenterol. 2017;112:1736–46.

    Article  PubMed  Google Scholar 

  26. Knudsen AB, Rutter CM, Peterse EFP, et al. Colorectal cancer screening: an updated modeling study for the US preventive services task force. JAMA. 2021;325:1998–2011.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Tokunaga M, Hiki N, Fukunaga T, et al. Laparoscopic surgery for synchronous gastric and colorectal cancer: a preliminary experience. Langenbecks Arch Surg. 2010;395:207–10.

    Article  PubMed  Google Scholar 

  28. Lieberman DA, Weiss DG, Bond JH, et al. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans affairs cooperative study group 380. N Engl J Med. 2000;343:162–8.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgement

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Funding

None of the authors had received any financial support from any institution.

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Authors and Affiliations

  1. Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan

    Yusuke Koseki MD, Makoto Hikage MD, PhD, Masanori Terashima MD, PhD, Kenichiro Furukawa MD, PhD, Keiichi Fujiya MD, PhD, Yutaka Tanizawa MD, PhD & Etsuro Bando MD, PhD

  2. Division of Surgery, Iwate Prefectural Isawa Hospital, Oshu, Japan

    Makoto Hikage MD, PhD

  3. Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan

    Akifumi Notsu PhD

  4. Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan

    Kazunori Takada MD & Kenichiro Imai MD

  5. Division of Colorectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan

    Akio Shiomi MD, PhD

Authors
  1. Yusuke Koseki MD
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  2. Makoto Hikage MD, PhD
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  3. Masanori Terashima MD, PhD
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  4. Akifumi Notsu PhD
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  5. Kenichiro Furukawa MD, PhD
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  6. Keiichi Fujiya MD, PhD
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  7. Yutaka Tanizawa MD, PhD
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  8. Kazunori Takada MD
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  9. Kenichiro Imai MD
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  10. Akio Shiomi MD, PhD
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  11. Etsuro Bando MD, PhD
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Contributions

YK, MH, and MT contributed to the study conception and design. AN, KF, YT, KT, KI, AS, and EB contributed to data acquisition. YK drafted the paper with contributions from MT. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Masanori Terashima MD, PhD.

Ethics declarations

M.T. reports receiving personal fees from Taiho Pharmaceutical, Chugai Pharmaceutical, Ono Pharmaceutical, BMS, Yakult Honsha, Takeda Pharmaceutical, Eli Lilly Japan, Pfizer Japan, Daiichi Sankyo, Johnson and Johnson, Medtronic Japan, Intuitive Japan, and Olympus outside the submitted work. E.B. reports receiving personal fees from Johnson and Johnson, Medtronic Japan, Intuitive Japan, and Kaken Pharmaceutical outside the submitted work. The other authors declare that they have no conflict of interest.

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Koseki, Y., Hikage, M., Terashima, M. et al. The Effectiveness of Screening Total Colonoscopy for Preoperative Patients with Gastric Cancer. Ann Surg Oncol 31, 762–771 (2024). https://doi.org/10.1245/s10434-023-14538-5

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  • DOI: https://doi.org/10.1245/s10434-023-14538-5

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