Fabrizio Parente1, Cristian Vailati2, Cinzia Boemo2, Emanuela Bonoldi3, Antonio Ardizzoia4, Antonina Ilardo5, Franco Tortorella5, Danilo Cereda6, Marco Cremaschini7, Roberto Moretti7. 1. Gastroenterology Department, A. Manzoni Hospital, Lecco, Italy. Electronic address: f.parente@ospedale.lecco.it. 2. Gastroenterology Department, A. Manzoni Hospital, Lecco, Italy. 3. Pathology Department, A. Manzoni Hospital, Lecco, Italy. 4. Oncology Department, A. Manzoni Hospital, Lecco, Italy. 5. Preventive Medicine, Local Health Care Centre Lecco, Italy. 6. Screening Unit, Regional Health Centre Milan, Italy. 7. Epidemiology, Local Health Care Centre, Bergamo, Italy.
Abstract
BACKGROUND: Colorectal cancer screening may reduce disease-related mortality by early-stage detection of cancers. AIMS: To study the effect of a single immunochemical faecal occult blood test (i-FOBt) screening round on reduction in colorectal cancer-related-mortality among average risk subjects. METHODS: Comparison of 5-year mortality rates in 3 cohorts from a Northern Italian province: (1) colorectal cancers detected at the 1st biennial round of a mass-screening programme targeting 50-69 years old subjects, (2) non-screening cancers symptomatically diagnosed during the same time period, and (3) cancers detected in the pre-screening biennium. Multivariate analyses were performed with the Cox regression model including tumour node metastasis (TNM) stage at diagnosis, anatomical distribution of cancers, age at diagnosis, gender and patient group. Kaplan-Meyer survival estimates and log-rank test for equality of survivor functions were calculated. RESULTS: Stage distribution significantly differed between screening and non-screening colorectal cancers: 73% of screen-detected colorectal cancers were stages I and II versus 43% and 40% of non-screening and pre-screening colorectal cancers. Cumulative 5-year mortality rate was significantly lower in screening compared to non-screening or pre-screening colorectal cancers patients (19% versus 37% and 41%, p < 0.001). CONCLUSIONS: Colorectal cancers were detected at earlier stages in i-FOBT-positive subjects in comparison with non-screening patients; colorectal cancers found at screening had a significantly improved 5-year survival.
BACKGROUND:Colorectal cancer screening may reduce disease-related mortality by early-stage detection of cancers. AIMS: To study the effect of a single immunochemical faecal occult blood test (i-FOBt) screening round on reduction in colorectal cancer-related-mortality among average risk subjects. METHODS: Comparison of 5-year mortality rates in 3 cohorts from a Northern Italian province: (1) colorectal cancers detected at the 1st biennial round of a mass-screening programme targeting 50-69 years old subjects, (2) non-screening cancers symptomatically diagnosed during the same time period, and (3) cancers detected in the pre-screening biennium. Multivariate analyses were performed with the Cox regression model including tumour node metastasis (TNM) stage at diagnosis, anatomical distribution of cancers, age at diagnosis, gender and patient group. Kaplan-Meyer survival estimates and log-rank test for equality of survivor functions were calculated. RESULTS: Stage distribution significantly differed between screening and non-screening colorectal cancers: 73% of screen-detected colorectal cancers were stages I and II versus 43% and 40% of non-screening and pre-screening colorectal cancers. Cumulative 5-year mortality rate was significantly lower in screening compared to non-screening or pre-screening colorectal cancerspatients (19% versus 37% and 41%, p < 0.001). CONCLUSIONS:Colorectal cancers were detected at earlier stages in i-FOBT-positive subjects in comparison with non-screening patients; colorectal cancers found at screening had a significantly improved 5-year survival.
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