A comparison of tumour and host prognostic factors in screen-detected versus non screen-detected colorectal cancer: a contemporaneous study

Mansouri, D. , McMillan, D. C. , McIlveen, E., Crighton, E. M., Morrison, D. and Horgan, P. G. (2016) A comparison of tumour and host prognostic factors in screen-detected versus non screen-detected colorectal cancer: a contemporaneous study. Colorectal Disease, 18(10), pp. 967-975. (doi: 10.1111/codi.13295) (PMID:26859503)

Abstract

Aim: In addition to TNM stage, there are adverse tumour and host factors, such as venous invasion and the presence of an elevated systemic inflammatory response (SIR) that influence the outcome in colorectal cancer. The present study aimed to examine how these factors varied in screen detected (SD) and non-screen detected tumours (NSD). Method: Prospectively maintained databases of the prevalence round of a biennial population FOBt screening programme and a regional cancer audit database were analysed. Interval cancers (INT) were defined as cancers identified within two years of a negative screening test. Results: Of the 395 097 invited, 204 535 (52%) responded, 6159 (3%) tested positive, and 421 (9%) had cancer detected. From this cohort, a further 708 (63%) NSD patients were identified (468 (65%) non-responders, 182 (25%) INT cancers and 58 (10%) did not attend or did not have cancer diagnosed at colonoscopy). Comparing SD and NSD patients, SD patients were more likely to be male, and have a tumour with a lower Dukes stage (both p<0.05). On stage-by-stage analysis, SD patients had less evidence of an elevated SIR (p<0.05). Both the presence of venous invasion (p=0.761) and an elevated SIR (p=0.059) were similar between those with INT cancers and in those that arose in non-responders. Conclusion: Independent of TNM stage, SD tumours have more favourable host prognostic factors than NSD tumours. There is no evidence that INT cancers are biologically more aggressive than those that develop in the rest of the population and hence are likely to be due to limitations of screening in its current format.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Mansouri, Mr David and Horgan, Professor Paul and Morrison, Dr David and McMillan, Professor Donald and McIlveen, Miss Erin
• Authors: Mansouri, D., McMillan, D. C., McIlveen, E., Crighton, E. M., Morrison, D., and Horgan, P. G.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Colorectal Disease
• Publisher: Wiley-Blackwell Publishing Ltd.
• ISSN: 1462-8910
• ISSN (Online): 1463-1318
• Published Online: 09 February 2016
• Copyright Holders: Copyright © 2016 The Association of Coloproctology of Great Britain and Ireland
• First Published: First published in Colorectal Disease 18(10): 967-975
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher