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Lead time bias in estimating survival outcomes
  1. Antonio Facciorusso1,
  2. Jose Ferrusquía2,
  3. Nicola Muscatiello1
  1. 1Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
  2. 2Gastroenterology and Hepatology Department, Central University Hospital of Asturias, Oviedo, Spain
  1. Correspondence to Dr Antonio Facciorusso, Gastroenterology Unit, Department of Medical Sciences, University of Foggia, AOU Ospedali Riuniti, Viale Pinto, 1, Foggia 71100, Italy; antonio.facciorusso{at}

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We read with great interest the article by Govindarajan et al,1 whose aim was to compare the survival outcomes among patients with postcolonoscopy colon rectal cancer (PCCRC), patients with colonoscopy-detected cancers and those diagnosed with CRC with no prior colonoscopy.

In this very well written paper, patients with PCCRC showed inferior survival time than colonoscopy-detected cancers, probably due to more advanced stages at diagnosis, while the worse outcomes were observed in those patients with no recent …

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