Screening Colonoscopy Associated With Increased Survival Duration and Rates For Patients With Colon Cancer

Patients with colon cancer identified on screening colonoscopy appear to have lower-stage disease on presentation and better outcomes independent of their staging, according to a report published Online First by JAMA Surgery, a JAMA Network publication.

Since their introduction in 2000, National Institutes of Health—recommended screening colonoscopy guidelines seemingly have consistently decreased overall rates of colorectal cancer in the United States.

Ramzi Amri, M.Sc., and colleagues of Massachusetts General Hospital and Harvard Medical School, Boston, examined the association of screening colonoscopy with outcomes of colon cancer surgery by reviewing differences in staging, disease-free interval, risk of recurrence, and survival and to identify whether diagnosis through screening was associated with long-term outcomes independent of staging.

Patients not diagnosed through screening were at risk for having more invasive tumors, nodal disease, and metastatic disease on presentation. In follow-up, these patients had higher death rates, and recurrence rates as well as shorter survival and disease-free intervals. After controlling for staging and baseline characteristics, the authors found that death rate and survival duration were better stage for stage with diagnosis through screening. Death and metastasis rates also remained lower among patients with tumors without nodal or metastatic spread.

“Compliance to screening colonoscopy guidelines can play an important role in prolonging longevity, improving quality of life, and reducing health care costs through early detection of colon cancer,” the authors conclude.

(JAMA Surgery. Published online June 19, 2013. doi:10.1001/jamasurg.2013.8.