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PTH-023 Screen Detected Colorectal Cancer: Benefits and Challenges of Catching Bhem Young
  1. S Ganapathi1,
  2. N Katsoulas1,
  3. R Hagger1,
  4. D Melville1,
  5. D Kumar1
  1. 1St. George’s Hospital, London, UK

Abstract

Introduction The bowel cancer screening programme (BCSP) is known to detect majority of colorectal cancer (CRC) at an earlier stage. We aimed at determining the outcome of screen detected CRC (SDCRC).

Methods 165 patients diagnosed with CRC through BCSP were compared to a control group, which included 179 age matched patients diagnosed with CRC before the implementation of BCSP. Survival analysis was performed at a median follow up of 36 months.

Results The SDCRC and control groups were similar with respect to gender distribution and vascular invasion (VI). SDCRC were more likely to be detected at an earlier Modified Dukes’ stage (p < 0.001). The stage distribution of SDCRC was similar to the national pilot (1) except for a higher percentage with metastatic disease (9% v 1%). During the follow up of SDCRC, 23 patients developed recurrent CRC and 19 patients died. While the overall survival (OS) was significantly better in SDCRC (p < 0.001), the recurrence free survival (RFS) in SDCRC was similar to the control group (p = 0.798). Left sided tumours (p = 0.022, HR-5.3) and VI (p = 0.004, HR-8.3) had an independent adverse influence on RFS in SDCRC. VI had a significant influence on RFS in both polyp (p = 0.006) and non-polyp cancers (p = 0.012) among SDCRC.

Conclusion While the OS was significantly better in the SDCRC, there was no significant difference in the RFS between the two groups. While the benefits of screening are clear, we need to be aware of the challenge posed by the expanding group of aggressive early CRC. Longer follow up is necessary to carefully quantify the survival and economic benefits achieved through NHS BCSP.

Disclosure of Interest None Declared.

Reference

  1. Results of the first round of a demonstration pilot of screening for colorectal cancer in the United Kingdom. BMJ 2004; 329:133.

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