AUTHOR=Spolverato Gaya , Capelli Giulia , Battagello Jessica , Barina Andrea , Nordio Susi , Finotti Elena , Mondi Isabella , Da Lio Corrado , Morpurgo Emilio , Navarro Josè Adolfo , Ceccato Fabio , Perin Alessandro , Pedrazzani Corrado , Turri Giulia , Zanus Giacomo , Campi Michela , Massani Marco , Di Giacomo Adriana , Prando Daniela , Agresta Ferdinando , Pucciarelli Salvatore , Zorzi Manuel , Rugge Massimo 

TITLE=More Favorable Short and Long-Term Outcomes for Screen-Detected Colorectal Cancer Patients

JOURNAL=Frontiers in Oncology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.620644

DOI=10.3389/fonc.2021.620644

ISSN=2234-943X

ABSTRACT=Background: Screening significantly reduces mortality from colorectal cancer (CRC). Screen detected (SD) tumors associate with better prognosis, even at later stage, compared to non-screen detected (NSD) tumors. We aimed to evaluate the association between diagnostic modality (SD vs. NSD) and short- and long-term outcomes of patients undergoing surgery for CRC. 
Materials and methods: This retrospective cohort study involved patients aged 50-69 years, residing in Veneto, Italy, who underwent curative-intent surgery for CRC between 2006 and 2018. The clinical multi-institutional dataset was linked with the screening dataset in order to define diagnostic modality (SD vs. NSD). Short- and long-term outcomes were compared between the two groups.
Results: Of 1360 patients included, 464 were SD (34.1%) and 896 NSD (65.9%). Patients with a SD CRC were more likely to have less comorbidities (p= 0.013), lower ASA score (p= 0.001), tumors located in the proximal colon (p=0.0018), and earlier stage at diagnosis (p<0.0001). NSD patients were found to have more aggressive disease at diagnosis, higher complication rate and higher readmission rate due to surgical complications (all p<0.05). NSD patients had a significantly lower Disease Free Survival and Overall Survival (all p<0.0001), even after adjusting by demographic, clinic-pathological, tumor and treatment characteristics.
Conclusions: SD tumors were associated with better long-term outcomes, even after multiple adjustment. Our results confirm the advantages for the target population to participate in the screening programs and comply with their therapeutic pathways.