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Are Outcomes Better in Patients Receiving FIT-Based Colorectal Cancer Screening?

By: Joseph Cupolo
Posted: Monday, December 3, 2018

One question kept Michael P. M. de Neree tot Babberich, MD, of the Academic Medical Center, Amsterdam, the Netherlands, and his colleagues searching for an answer: Do patients referred through the fecal immunochemical test-(FIT)-based colorectal cancer screening program have better surgical outcomes than non–screen-detected patients? Their study of 18,826 patients appears to demonstrate that those with screen-detected colon cancer had significantly lower odds of postoperative complications. 

Published in JAMA Surgery, this population-based comparative cohort study used the Dutch ColoRectal Audit and analyzed all Dutch hospitals performing colorectal cancer resections. A risk-stratified comparison was made for different postoperative outcomes based upon screening status, cancer stage (I to IV), age ( ≤ 70 years and > 70 years), and American Society of Anesthesiologists score (I to II and III to IV). Compared with patients who had non–screen-detected colorectal cancer, screen-detected patients were younger, more often men, and had lower American Society of Anesthesiologists scores.

Patients with stage I to III colon cancer who were screen detected had a significantly lower mortality and complicated course rate than did non–screen-detected patients. Of note, for patients with rectal cancer, a significant difference was found in the mortality rate in patients with a cancer stage IV disease, which was higher in the screen-detected group.

“Researchers of future studies on surgical outcomes of colorectal cancer treatment should be aware of the differences between patients detected through the screening program and non–screen-detected patients and, consequently, take this into account in their comparison models,” the investigators advised.

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