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Improved survival of patients with colon cancer detected by screening colonoscopy

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Screening for colon cancer (CC) may not only reduce its occurrence but has also the potential to reduce the overall mortality. So far, there has been little evidence that detection of colon cancer by screening colonoscopy results in different survival rates compared to symptomatic patients.

Patients and methods

Clinical, histological, diagnostic, and survival data of 1016 consecutive patients with CC from a prospectively expanded single-institutional database were analyzed for diagnostic, treatment, and prognostic factors. Findings were then stratified according to detection by screening colonoscopy vs. patients who became symptomatic prior to further diagnostic work-up.

Results

7.1 % of all patients were identified by screening colonoscopy for colon cancer. Screened patients were younger (68.2 vs. 64.8 years), had smaller T stage (p = 0.032), lower tumor stage (p = 0.009), and a tendency to less lymph node metastasis. Overall survival was superior in screened patients, and stage-specific survival showed a tendency to improved survival, which was not statistically significant. Furthermore, a higher percentage of screened patients underwent adjuvant chemotherapy (84.6 vs. 55.0 %, p = 0.032).

Conclusion

Survival outcome and enrollment in a multimodal treatment was higher in screening-detected patients compared to patients diagnosed after the onset of clinical symptoms. Besides a potential occurrence of lead time bias, these findings strongly support the need for continued improvement of screening programs and the recruitment of more patients for colorectal cancer screening.

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Acknowledgments

We thank Mrs. L. Stevenson for critically reading the scientific text. This publication was funded by the German Research Foundation (DFG) and the University of Wuerzburg in the funding program Open Access Publishing. No current external other funding sources for this study are to be declared.

Authors’ contribution

AW conducted the data collection. AW, SA, and JR performed the analyses. AW, UD, OG, CTG, and IK interpreted the results of analyses. All authors prepared, reviewed, and gave critical input into each stage of the preparation of the manuscript.

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Authors and Affiliations

  1. Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr. 2, 97080, Wuerzburg, Germany

    Armin Wiegering, Sabine Ackermann, Johannes Riegel, Ulrich A. Dietz, Christoph-Thomas Germer & Ingo Klein

  2. Department of Biochemistry and Molecular Biology, University of Wuerzburg, Oberduerrbacherstr. 2, 97074, Wuerzburg, Germany

    Armin Wiegering

  3. Department of Medicine II, Division of Gastroenterology and Hepatology, University Hospital Würzburg, Oberduerrbacherstr. 2, 97074, Wuerzburg, Germany

    Oliver Götze

  4. Comprehensive Cancer Centre Mainfranken, University Hospital, University of Wuerzburg, Josef-Schneiderstr. 6, 97080, Wuerzburg, Germany

    Christoph-Thomas Germer & Ingo Klein

  5. Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, Julius-Maximilian’s University, Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany

    Armin Wiegering & Ingo Klein

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  1. Armin Wiegering
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  2. Sabine Ackermann
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  3. Johannes Riegel
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  4. Ulrich A. Dietz
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Correspondence to Armin Wiegering or Ingo Klein.

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Wiegering, A., Ackermann, S., Riegel, J. et al. Improved survival of patients with colon cancer detected by screening colonoscopy. Int J Colorectal Dis 31, 1039–1045 (2016). https://doi.org/10.1007/s00384-015-2501-6

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  • DOI: https://doi.org/10.1007/s00384-015-2501-6

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