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Article

Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test

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Altza Primary Care Health Center, OSI Donostialdea; Biodonostia Health Research Institute, 20014 San Sebastián, Spain
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Biodonostia Health Research Institute, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Hospital Universitario Donostia, 20014 San Sebastian, Spain
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Gastroenterology Department, Complexo Hospitalario Universitario de Ourense, 32005 Ourense, Spain
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Colorectal Cancer Screening Programme, Osakidetza, Basque Health Service, 48010 Bilbao, Spain
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Gastroenterology Department, Osakidetza, Hospital Universitario Donostia, Biodonostia Health Research Institute, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), University of the Basque Country (UPV/EHU), 20014 San Sebastián, Spain
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(9), 2412; https://doi.org/10.3390/cancers12092412
Received: 23 July 2020 / Revised: 14 August 2020 / Accepted: 20 August 2020 / Published: 25 August 2020
(This article belongs to the Special Issue New Insights into Colorectal Cancer)
Population screening has improved early diagnosis of colorectal cancer (CRC). Nonetheless, most cases are diagnosed in symptomatic patients. Faecal immunochemical testing has been recommended for assessing patients with lower gastrointestinal symptoms, but whether it improves patient survival is unknown. Our objective was to compare CRC survival in 50- to 69-year-olds between asymptomatic screen-detected patients and symptomatic patients by route to diagnosis. Methods: We identified all cases of CRC diagnosed in 50-to 69-year-olds between 2009 and 2016, in Donostialdea (Gipuzkoa, Spain). Three groups were created: 1-screen-detected CRC; 2-CRC detected in symptomatic patients after a positive faecal immunochemical test(FIT); and 3-CRC detected in symptomatic patients without a FIT or after a negative result. We analysed survival using the Kaplan-Meier method and log-rank tests. Results: Of 930 patients diagnosed with CRC, 433 cases were detected through screening and 497 in symptomatic patients, 7.9% after a positive FIT and 45.5% by other means. The 3-year CRC survival was significantly lower in group 3 (69.5%) than groups 1 (93%; p = 0.007) or 2 (87.5%; p = 0.02). The risk of death was lower in groups 1 (HR 0.42, 95% CI 0.30–0.58) and 2 (HR 0.51; 95% CI 0.29–0.87). Conclusion: Half of CRC cases in 50- to 69-year-olds are diagnosed outside screening. Use of the FIT as a diagnostic strategy in symptomatic patients may improve survival. View Full-Text
Keywords: colorectal cancer; faecal immunochemical test; survival colorectal cancer; faecal immunochemical test; survival
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MDPI and ACS Style

Gutierrez-Stampa, M.A.; Aguilar, V.; Sarasqueta, C.; Cubiella, J.; Portillo, I.; Bujanda, L. Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test. Cancers 2020, 12, 2412. https://doi.org/10.3390/cancers12092412

AMA Style

Gutierrez-Stampa MA, Aguilar V, Sarasqueta C, Cubiella J, Portillo I, Bujanda L. Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test. Cancers. 2020; 12(9):2412. https://doi.org/10.3390/cancers12092412

Chicago/Turabian Style

Gutierrez-Stampa, María Angeles, Vanessa Aguilar, Cristina Sarasqueta, Joaquín Cubiella, Isabel Portillo, and Luis Bujanda. 2020. "Colorectal Cancer Survival in 50- to 69-Year-Olds after Introducing the Faecal Immunochemical Test" Cancers 12, no. 9: 2412. https://doi.org/10.3390/cancers12092412

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