Clinical–alimentary tractMicrosatellite Instability in Interval Colon Cancers
Section snippets
Selection of Study Subjects
All veterans with a diagnosis of cancer at the Minneapolis Veterans Affairs Medical Center are entered into a cancer registry and are monitored for lifetime follow-up. The registry currently has data on 34,738 patients with cancer and has consistently achieved >95% follow-up. We searched the cancer registry from January 1, 1989, to December 31, 2004, and identified all patients with incident colon cancer. We excluded those with familial adenomatous polyposis or inflammatory bowel disease.
Results
During the specified period, 993 patients with colon cancer were identified from the Minneapolis Veterans Affairs Medical Center cancer registry and met entry criteria for the study. Of these, 51 patients developed colon cancers within 5 years of their most recent colonoscopy and were termed interval cancers. These interval cancers accounted for 5.1% of all colon cancers diagnosed at our institution. During the same period, 112 patients with noninterval colon cancer were selected (as described
Discussion
We found evidence to support that interval cancers were more likely than noninterval cancers to represent tumors with a biological propensity for rapid growth. Interval cancers had nearly 4 times the odds of demonstrating MSI when compared with noninterval cancers, an association that was strongest for tumors located in the distal colon. Interval cancers were also more likely to be located in the proximal colon and were smaller in size than noninterval cancers. Unexpectedly, we found a trend
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Supported in part by the VA Clinical Science R&D Service (grant 04S-CRCOE-001 to M.S.S. and T.S.R.) and a grant from the Minnesota Medical Foundation (Minneapolis, MN).