Incidence of interval colorectal cancer: A tertiary hospital report

Introduction Screening and early detection reduce morbidity and mortality in colorectal cancer. Our aim is to study the effect of income disparities on the clinical characteristics of patients with colorectal cancer in Massachusetts. Methods Patients were extracted from a database containing all surgically treated colorectal cancers between 2004 and 2015 at a tertiary hospital in Massachusetts. We split patients into 2 groups: “above-median income” and “below-median income” according to the median income of Massachusetts ($74,167). Results The analysis included 817 patients. The above-median income group consisted of 528 patients (65%) and the below-median income group consisted of 289 patients (35%). The mean age of presentation was 64 ± 15 years for the above-median income group and 67 ± 15 years for the below-median income group ( P = .04). Patients with below-median income were screened less often ( P < .001) and presented more frequently with metastatic disease ( P = .02). Patients with above-median income survived an estimated 15 months longer than those with below-median income ( P < .001). The survival distribution was statistically significantly different between the groups for stage III disease ( P = .004), but not stages I, II, or IV ( P = 1, 1, and .2, respectively). For stage III disease, a lower proportion of below-median income patients received chemotherapy (61% vs. 79%, P = .002) and a higher proportion underwent nonelective surgery (5% vs. 2%, P = .007). Conclusions In Massachusetts, patients with colorectal cancer residing in lower income areas are screened less, received adjuvant chemotherapy less, and have worse outcomes, especially when analyzing those who present with stage III disease.

Download Full-text

EP.TU.660The rate of interval colorectal cancer within 5 years of a negative colonoscopy at a district general hospital

British Journal of Surgery ◽

10.1093/bjs/znab311.091 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Abdullah Alqallaf ◽

Aimee Grant ◽

Corina Lavelle ◽

Palanichamy Chandran

Keyword(s):

Colorectal Cancer ◽

Short Interval ◽

Interval Cancer ◽

District General Hospital ◽

Colorectal Cancers ◽

Right Colon ◽

Adenoma Detection ◽

Technical Factors ◽

Interval Colorectal Cancer ◽

Repeat Procedures

Abstract Aims Interval colorectal cancer is defined as cancer that has developed within a short interval of a diagnostic test that did not detect a cancer. Many authors define this interval as five years, though more complex definitions of interval cancer have been proposed. Our aim was to determine what percentage of colorectal cancers diagnosed at our hospital had a negative colonoscopy within the 5 years prior to their diagnosis. Methods We obtained details of all colorectal cancers diagnosed between 2017-2019 at our department. We then surveyed the endoscopy system to detect the patients who had a negative colonoscopy within the 5 years prior to their diagnosis, to calculate what percentage of cancers diagnosed within that period were interval cancers. Results Between 2017-2019, 539 patients were diagnosed with colorectal cancer. Age at diagnosis varied widely from 21 to 107, and 310 (57.5%) of patients were male. Seventeen patients had a negative colonoscopy within 5 years (though two of these were planned repeat procedures within a few months of the index ‘negative’ colonoscopy). We can therefore calculate the rate of interval cancer at 3.1% between 2017-2019. Conclusions The aetiology of interval colorectal cancer has been attributed to patient/tumour factors (right colon and female sex) and technical factors (adenoma detection and caecal intubation rate). Though the rate of interval cancer at our department seems pleasingly low compared to the literature, we plan to investigate the risk factors that might be at play: are biological factors to blame or can our endoscopy service be improved?

Download Full-text