Most colorectal cancer deaths linked to modifiable screening failures
Staying up to date on screening can markedly reduce a patient’s risk for death from colorectal cancer, according to research published in Gastroenterology.
Chyke A. Doubeni, MD, MPH, of the Perelman School of Medicine at the University of Pennsylvania, and colleagues wrote that most people who died of CRC did not stay up to date and experienced other rectifiable failures in their screening process.
“This is a study of people who died from colorectal cancer as well as a randomly selected group of people who did not [die of] colorectal cancer,” Doubeni told Healio Gastroenterology and Liver Disease. “We found that patients who were not up to date on screening had a 2.6-fold higher risk of dying from colorectal cancer compared to those who were up to date, particularly for those who did not receive follow-up testing after an abnormal result – those patients had about sevenfold higher risk of death from colorectal cancer.”
Doubeni and colleagues conducted a retrospective cohort study of patients (aged 55-90 years) in the Kaiser Permanente Northern and Southern California systems who died of CRC between 2006 and 2012 and had at least five years of enrollment prior to diagnosis. They compared data — such as receipt, results, indications and follow-up of CRC tests — from those patients with a match cohort of cancer-free patients.
Investigators found that patients who were not up to date in screening accounted for more CRC deaths (n = 1,328; 75.9%) compared with patients who were up to date (n = 422; 24.1%). Patients who were up to date had a reduced risk for CRC death (OR = 0.38; 95% CI, 0.33–0.44).
Among patients who died of CRC, 67.4% experienced failure to screen or failure to screen at appropriate intervals compared with 53.2% of patients without cancer. A higher percentage also experienced failure to follow up on abnormal results (8.1% vs. 2.2%).
Doubeni and colleagues found that death from CRC was associated with failure to screen or failure to screen at appropriate intervals (OR = 2.4; 95% CI, 2.07–2.77), and failure to follow up on abnormal results (OR = 7.26; 95% CI, 5.26–10.03).
“These results show the importance for patients to screen for colorectal cancer when due and ensure that those with abnormal or incomplete receive timely follow-up testing,” Doubeni said. – by Alex Young
Disclosures: Doubeni reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.