Is CRC Found by Screening Associated With Improved Outcomes?

Stage III and stage IV colorectal cancer was less extensive, and survival better, in patients whose cancer was detected through a nationwide screening program compared with clinical detection, according to a study published in Clinical Gastroenterology and Hepatology.

“Biennial fecal immunochemical test screening started in the Netherlands in 2014 for individuals 55–75 years of age,” researchers explained in the study background. “This study investigated the effect of screening on stage-specific incidence, with focus on stage III and IV colorectal cancer.”

The study included 140,649 colorectal cancers detected in 136,882 patients between 2009 and 2018.

After national screening began, diagnoses of colorectal cancer stages I through III peaked initially but then decreased among people of ages eligible for screening. While the total incidence of colorectal cancer remained higher than before national screening, the incidence of stage II and stage IV colorectal cancer fell below prescreening levels 5 years after the program’s start, according to the study.

Colorectal cancers detected through screening were more frequently located in the left-sided colon, researchers reported, and the primary tumor resection rate was higher. Patients with screening-detected stage IV colorectal cancer more often had single-organ metastases and received treatment with curative intent.

“Overall survival significantly improved for patients with screen-detected colorectal cancers,” researchers wrote.

—Jolynn Tumolo

Reference
Krul MF, Elferink MAG, Kok NFM, et al. Initial impact of national CRC screening on incidence and advanced colorectal cancer. Clin Gastroenterol Hepatol. Published online September 15, 2022. doi:10.1016/j.cgh.2022.08.046