scholarly journals Risk Factors for Progression from Early to Advanced Stage Mycosis Fungoides: A Single Center Retrospective Analysis at the Winship Cancer Institute of Emory University

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1378-1378
Author(s):  
Pamela Allen ◽  
Ashley Alesia McCook ◽  
Jeffrey M. Switchenko ◽  
Shaunak Varma ◽  
Mary Jo Lechowicz ◽  
...  
Keyword(s):  
Blood Flow ◽  
Median Survival ◽  
Early Stage ◽  
Peripheral Blood Flow ◽  
Advanced Stage ◽  
Stage At Diagnosis ◽  
Risk Of Death ◽  
Disease Characteristics ◽  
Increased Risk ◽  
Emory University

Abstract Introduction: Advanced stage mycosis fungoides (MF) has a median survival of 3-5 years, while early stage MF is a chronic disease typically associated with an excellent prognosis and a median survival of 20 years or more. Prior studies suggest approximately 20% of early stage MF may progress to advanced stage, but risk factors for progression remain poorly studied, particularly among African American (AA) patients. We aimed to identify clinic features associated with progression to advanced stage MF in a large urban medical center. Methods We performed a retrospective review of 388 patients with early stage (1A-2A) MF at the Winship Cancer Institute of Emory University diagnosed between 1970 and 2021. Clinical data collected from the electronic medical record included demographics, laboratory values, disease characteristics, and therapy. Our primary endpoint was to identify variables associated with progression to advanced stage MF. Progression to advanced stage was defined as a highest overall TNMB stage of 2B-4B. Overall survival (OS) was measured from time of diagnosis to date of death or last follow-up. Kaplan-Meier curves for OS were generated for the whole cohort and by progression group. Descriptive analysis was performed for each variable, and a comparison between patients who did or did not progress to advanced stage was performed using ANOVA for numerical covariates and chi-square test for categorical covariates. The association of baseline variables with OS was modeled by Cox proportional hazards model and multivariable analyses were performed on significant variables. Results Among 388 patients, the median follow up was 5 years (range 0-51). There was even distribution among male (49.0%) and female (51.0%) patients. The median age at diagnosis was 53 years (range 8-95). This population included 41.4% AA, 55.0% White, 2.3% Asian, and 1.3% other races. Stage distribution was as follows: 34.2% (n=133) stage 1A, 51.5% stage 1B (n=200), and 14.2% stage 2A (n=55). Forty-nine patients had hypopigmented MF (45 AA), and 9.4% (n=34) patients developing large cell transformation (LCT) during their disease course. Treatment at diagnosis was topical in 52.3% (n=203), systemic in 1.8% (n=7), radiation in 3.4% (n=13), and multimodality in 29.4% (n=114). Overall, 93 patients (24.1%) progressed to advanced stage. Progression to a higher stage was statistically associated with higher overall TNMB stage at diagnosis (p<0.001), T2 tumor stage (p<0.001), nodal involvement (p=0.031), positive blood flow cytometry (<0.001), T-cell receptor (TCR) clonality in the blood (p=0.014), LCT (p<0.001), and elevated lactate dehydrogenase (LDH) (p<0.001). Patients with hypopigmented MF were less likely to progress (hazard ratio 0.32 (95% CI 0.12-0.84) p=0.020), Sex, race, age, blood stage, and white blood cell count were not associated with risk for progression. Univariate logistic regression is summarized in figure 1. Progression to advanced stage was associated with an increased risk of death (4.75 (0.05-7.38), p < 0.001, figure 2). The median survival for patients who did and did not progress were 11 years (95% CI 7, 15) and 31 years (95% CI 25, not reached), p<0.001 respectively. Other factors associated with an increased risk of death included age > 60 (p <0.001), higher TNMB stage at diagnosis (log rank p<0.001), advanced nodal stage, (p=0.005), positive peripheral blood flow (p=0.010), TCR clonality in the blood (p=0.039), LCT (p< 0.001), elevated LDH (p<0.001), and elevated WBC (p<0.001), while hypopigmented MF was associated with a decreased risk of death (0.28 (0.09-0.90), p=0.021). On multivariable survival analysis controlling for hypopigmented MF, LCT, and stage at diagnosis, only age > 60 (3.32 (2.00-5.51), p<.001) and progression to advanced stage (4.02 (2.38-6.79), p<0.001) remained statistically significant. Conclusions We demonstrate that progression to advanced stage is associated with several baseline laboratory and disease characteristics, which bear immediate clinical relevance to the work up and staging of early stage MF. These data suggest that consistent staging and laboratory analyses with imaging for lymph node assessment, peripheral blood flow cytometry, and TCR in all newly diagnosed MF patients may aid in identifying patients at risk for progression to advanced stage disease. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals De-escalation of radiation therapy in patients with stage I, node-negative, HER2-positive breast cancer

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jose G. Bazan ◽  
Sachin R. Jhawar ◽  
Daniel Stover ◽  
Ko Un Park ◽  
Sasha Beyer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Local Therapy ◽  
Adjuvant Radiation ◽  
Her2 Positive ◽  
Node Negative ◽  
Risk Of Death ◽  
Her2 Breast Cancer ◽  
Neoadjuvant Systemic Therapy ◽  
Increased Risk

AbstractIn the modern era, highly effective anti-HER2 therapy is associated with low local-regional recurrence (LRR) rates for early-stage HER2+ breast cancer raising the question of whether local therapy de-escalation by radiation omission is possible in patients with small-node negative tumors treated with lumpectomy. To evaluate existing data on radiation omission, we used the National Cancer Database (NCDB) to test the hypothesis that RT omission results in equivalent overall survival (OS) in stage 1 (T1N0) HER2+ breast cancer. We excluded patients that received neoadjuvant systemic therapy. We stratified the cohort by receipt of adjuvant radiation. We identified 6897 patients (6388 RT; 509 no RT). Patients that did not receive radiation tended to be ≥70 years-old (odds ratio [OR] = 3.69, 95% CI: 3.02–4.51, p < 0.0001), to have ≥1 comorbidity (OR = 1.33, 95% CI: 1.06–1.68, p = 0.0154), to be Hispanic (OR = 1.49, 95% CI: 1.00–2.22, p = 0.049), and to live in lower income areas (OR = 1.32, 95% CI: 1.07–1.64, p = 0.0266). Radiation omission was associated with a 3.67-fold (95% CI: 2.23–6.02, p < 0.0001) increased risk of death. While other selection biases that influence radiation omission likely persist, these data should give caution to radiation omission in T1N0 HER2+ breast cancer.

Primary signet ring cell histology does not portend worse survival for early stage lung cancer following lobectomy

2021 ◽  
pp. 021849232110459
Author(s):  
Terrance Peng ◽  
Anita Yau ◽  
Li Ding ◽  
Elizabeth A. David ◽  
Sean C. Wightman ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Early Stage ◽  
Signet Ring Cell ◽  
Rank Test ◽  
Poor Prognostic Factor ◽  
Risk Of Death ◽  
Increased Risk ◽  
Signet Ring ◽  
Ring Cell ◽  
The Impact

Introduction Signet ring cell (SRC) histology is considered a poor prognostic factor in various cancers. However, primary SRC lung adenocarcinoma is rare and poorly understood. Methods The National Cancer Database was queried to identify treatment-naïve patients who received lobectomy for primary SRC or non-SRC pT1-2N0 lung adenocarcinoma <4 cm within four months of diagnosis. SRC lung adenocarcinoma was defined by ICD-O-3 code 8490, while non-SRC lung adenocarcinoma was defined by ICD-O-3 codes 8140, 8141, 8143, 8147, 8255, 8260, 8310, 8481, 8560, and 8570–8574. The Kaplan-Meier curve and log-rank test was used to compare five-year OS between SRC versus non-SRC lung adenocarcinoma cohorts. The impact of SRC histology on risk of death was assessed using the Cox proportional hazards regression model. Results 48,399 patients were included in this study: 62 with primary SRC lung adenocarcinoma and 48,337 with non-SRC lung adenocarcinoma. The mean age of the overall cohort was 67.0 ± 9.6 years. Five-year OS following lobectomy did not differ significantly between SRC lung adenocarcinoma and non-SRC lung adenocarcinoma cohorts (SRC 73.9% vs. non-SRC 69.3%, p = 0.64). SRC histology did not significantly impact risk of death within five years after lobectomy (HR 0.89, p = 0.66). Conclusions Following lobectomy for pT1-2N0 tumors <4 cm, patients with primary SRC lung adenocarcinoma do not experience worse five-year OS or increased risk of death within five years relative to those with non-SRC lung adenocarcinoma. Additional study, including exploration of emerging molecular profiling data, may serve to better define optimal treatment for this histopathologic group of lung adenocarcinomas.

scholarly journals Outcomes after Mastectomy and Lumpectomy in Octogenarians and Nonagenarians with Early-Stage Breast Cancer

2017 ◽  
Vol 83 (8) ◽  
pp. 887-894 ◽  
Author(s):  
Ameliay Merrill ◽  
Doris R. Brown ◽  
Heidi D. Klepin ◽  
Edward A. Levine ◽  
Marissa Howard-Mcnatt
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Early Stage ◽  
Clinical Stage ◽  
Univariate Analysis ◽  
Local Treatment ◽  
Breast Conservation ◽  
Early Stage Breast Cancer ◽  
Risk Of Death ◽  
Increased Risk

Prospective studies have shown equal outcomes after mastectomy or breast conservation in patients with invasive breast cancer; however, many of these studies excluded elderly patients. We identified patients in their eighties and nineties with clinical stage 0 to II breast cancer undergoing mastectomy or lumpectomy with or without radiation from the prospective sentinel lymph node database at Wake Forest Baptist Health and analyzed their treatment and survival. Of 92 patients, 24 (26.1%) underwent mastectomy, 22 (23.9%) lumpectomy with radiation, and 46 (50.0%) lumpectomy alone. Significant differences were noted in tumor size (P = 0.018), nodal status (P = 0.013), and stage (P = 0.011) between the groups. Only 7.6 per cent of patients had chemotherapy, whereas 51.1 per cent took antiestrogen therapy. Recurrence occurred in 11 patients. In univariate analysis, overall survival did not differ by surgery. Age was the only factor that increased risk of death (HR = 1.19, P = 0.028). In this age group, neither tumor factors nor the type of local treatment significantly influenced overall survival. Octogenarians and nonagenarians with early-stage breast cancer undergoing breast-conserving surgery with or without radiation have equivalent survival to patients having a mastectomy.

scholarly journals Gallbladder cancer revisited: the evolving role of a radiologist

2021 ◽  
Vol 94 (1117) ◽  
pp. 20200726
Author(s):  
Anupama Ramachandran ◽  
Deep Narayan Srivastava ◽  
Kumble Seetharama Madhusudhan
Keyword(s):  
Gallbladder Cancer ◽  
Surgical Resection ◽  
Median Survival ◽  
Multidisciplinary Approach ◽  
Early Stage ◽  
Survival Duration ◽  
Advanced Stage ◽  
Complete Surgical Resection ◽  
Common Malignancy

Gallbladder cancer is the most common malignancy of the biliary tract. It is also the most aggressive biliary tumor with the shortest median survival duration. Complete surgical resection, the only potentially curative treatment, can be accomplished only in those patients who are diagnosed at an early stage of the disease. Majority (90%) of the patients present at an advanced stage and the management involves a multidisciplinary approach. The role of imaging in gallbladder cancer cannot be overemphasized. Imaging is crucial not only in detecting, staging, and planning management but also in guiding radiological interventions. This article discusses the role of a radiologist in the diagnosis and management of gallbladder cancer.

Prognostic implication of KIT mutations in melanoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9049-9049
Author(s):  
Katherine G. Roth ◽  
Emily C. Zabor ◽  
Marta N. Colgan ◽  
Jedd D. Wolchok ◽  
Paul B. Chapman ◽  
...  
Keyword(s):  
Cox Regression ◽  
Chi Square ◽  
Risk Of Death ◽  
Disease Characteristics ◽  
Kaplan Meier ◽  
Increased Risk ◽  
History Of ◽  
Genetic Subgroup ◽  
Prognostic Implications

9049 Background: The natural history of BRAF and NRAS mutant (mut) melanoma (mel) has been described, but prognostic implications of KIT mut mel have not. Methods: We performed a single-center retrospective review of 180 patients (pts) enriched for mucosal, acral or chronic sun-damaged skin (CSD) mel and screened for KIT, BRAF, and NRAS mut from 4/07 - 4/10 as a part of a phase II imatinib study. Pt/disease characteristics were compared using the Kruskal-Wallis or Chi-square tests. Factors associated with outcomes were assessed by Kaplan-Meier methods and multivariable Cox regression. Results: Median age, 63.7 years; 54.4% male. Primary site: 40% mucosal, 29% acral, 22% CSD, 9% others. Mut rate: 18% KIT, 16% BRAF, 14% NRAS, 52% wild-type (wt). Pathologic subtype differed by genetic subgroup (p<.001) while age, gender, and stage did not (all p>0.05). 18/26 (69%) KIT mut pts received imatinib in the metastatic (met) setting; 6/18 received > 1 other KIT inhibitor. 3/25 (12%) BRAF mut pts received vemurafenib. 8/27 (30%) KIT mut, 4/27 (15%) BRAF mut, 6/20 (30%) NRAS mut, and 6/20 (30%) wt pts received ipilimumab. 149/180 (83%) pts developed mets at a median of 2.15 years (95% CI: 1.72, 2.72). Median follow-up (FU) of pts not developing mets was 3.91 yrs (range: 0.25, 14.34). Older age (HR: 1.02, 95% CI: 1.00, 1.03) and pathologic subtype (mucosal vs CSD HR: 1.70, 95% CI: 1.02, 2.84; non-CSD/unknown vs CSD HR: 2.05, 95% CI: 1.00, 4.21) were associated with increased risk of mets but not with time from mets to death. Of 149 pts who progressed, 123 (83%) died during FU. Median time from met to death was 1.21 years (95% CI: 0.91, 1.67). Median FU from time of mets among those alive at last FU was 2.53 yrs (range: 0.06, 6.85). Mut status including KIT mut was not associated with time to first met or time from met to death. Pts who received ipilimumab from time of first distant met had reduced risk of death (HR: 0.55, 95% CI: 0.36, 0.87) independent of mut status. No impact was observed with KIT inhibition. Conclusions: KIT mut status is not an independent predictor of time to mets or survival in pts with mets. Ipilimumab improved pt outcomes regardless of mut status. The lack of impact of KIT inhibitors is likely due to the heterogeneity of KIT mut in mel but does not preclude efficacy in appropriately selected pts.

scholarly journals Survival for Patients With Invasive Cutaneous Melanoma Among Ethnic Groups: The Effects of Socioeconomic Status and Treatment

2008 ◽  
Vol 26 (1) ◽  
pp. 66-75 ◽  
Author(s):  
Jason A. Zell ◽  
Pelin Cinar ◽  
Mehrdad Mobasher ◽  
Argyrios Ziogas ◽  
Frank L. Meyskens ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
African Americans ◽  
Cutaneous Melanoma ◽  
Census Data ◽  
Early Stage ◽  
Large Population ◽  
Poor Survival ◽  
Anatomic Site ◽  
Risk Of Death ◽  
Increased Risk

PurposeAlthough uncommon, melanoma is associated with poor survival characteristics among African Americans and Hispanics compared with non-Hispanic whites (NHWs). Low socioeconomic status (SES) is also associated with poor survival among patients with melanoma, but it is not known whether this is because of SES itself or because of treatment disparities. We set out to determine this by using the large, population-based California Cancer Registry (CCR) database as a model.Patients and MethodsWe conducted a case-only analysis of CCR data (1993 to 2003), including a descriptive analysis of relevant clinical variables and SES. The SES variable used has been derived from principle component analysis of census block-level CCR data that was linked to census data to address seven indicators of SES. Univariate analyses of overall survival (OS) were conducted using the Kaplan-Meier method. Multivariate survival analyses were performed using Cox proportional hazard ratios (HRs).ResultsA total of 39,049 incident patient cases of cutaneous melanoma, including 36,694 in NHWs; 127 in African Americans; 1,996 in Hispanics; and 262 in Asian-Americans, were analyzed. Higher SES was associated with an early stage at presentation (P < .0001), with treatment with surgery (P = .0005), and with prolonged survival (P < .0001). After adjustments for age, sex, histology, American Joint Committee on Cancer stage, anatomic site, treatment, and SES, a statistically significant increased risk of death was observed for African Americans compared with NHWs (HR, 1.60; 95% CI, 1.17 to 2.18); no survival differences were noted for Asians or Hispanics compared with NHWs in the adjusted analysis.ConclusionLow SES independently predicts poor outcome among patients with cutaneous melanoma. However, the poor OS observed for African American patients with melanoma is not explained by differences in treatment or SES.

Influence of Comorbidities and Age on Risk of Death Without Recurrence: A Retrospective Analysis of the Arimidex, Tamoxifen Alone or in Combination Trial

2011 ◽  
Vol 29 (32) ◽  
pp. 4266-4272 ◽  
Author(s):  
Alistair Ring ◽  
Ivana Sestak ◽  
Michael Baum ◽  
Anthony Howell ◽  
Aman Buzdar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Analysis ◽  
Early Stage ◽  
Double Blind ◽  
Risk Of Recurrence ◽  
Risk Of Death ◽  
Increased Risk ◽  
Competing Causes ◽  
To Receive ◽  
Related Mortality

Purpose The Arimidex, Tamoxifen Alone or in Combination (ATAC) study was a double-blind randomized trial in which postmenopausal women with early-stage breast cancer were assigned to receive anastrozole, tamoxifen, or the combination. We have conducted a retrospective analysis to examine the effects of comorbidities and age on treatment received, breast cancer–related mortality, and competing causes of mortality. Patients and Methods The current analyses were based on 10-year median follow-up data in the two monotherapy arms (anastrozole, n = 3,092; tamoxifen, n = 3,094) of the ATAC study. Baseline comorbidities and tumor and treatment characteristics were compared between women age less than 70 years and women age ≥ 70 years. The cumulative incidence of breast cancer–related and non–breast cancer–related mortality was assessed according to age and comorbidities. Results One thousand six hundred sixty-two patients (27%) were age ≥ 70 years at study entry. Older women were more likely to undergo mastectomy (odds ratio [OR], 1.92; 95% CI, 1.71 to 2.16) and less likely to receive radiotherapy (OR, 0.49; 95% CI, 0.44 to 0.55) or chemotherapy (OR, 0.24; 95% CI, 0.18 to 0.29). Women age ≥ 70 years had an increased risk of recurrence compared with women age less than 70 years (hazard ratio [HR], 1.21; 95% CI, 1.08 to 1.37) and a substantially increased risk of death without recurrence (HR, 4.13; 95% CI, 3.53 to 4.83). The risk of death without recurrence increased with comorbidity score (10-year estimates of 8.4%, 20.0%, and 30.4% for Satariano score 0, 1, and 2+, respectively; P < .001). Conclusion Age influences the risk of recurrence, and age and comorbidities significantly influence the risk of death without recurrence. Formal assessment of comorbidities should be incorporated into decisions regarding adjuvant therapies.

scholarly journals SCREENING POLICIES FOR OVARIAN CANCER IN NIGERIAN HOSPITALS: A REVIEW

2021 ◽  
Vol 9 (10) ◽  
pp. 663-666
Author(s):  
Worship Odosa Agbonifo
Keyword(s):  
Ovarian Cancer ◽  
Early Stage ◽  
Screening Method ◽  
Screening Tests ◽  
Advanced Stage ◽  
Stage At Diagnosis ◽  
Effective Screening ◽  
Current State ◽  
Screening Strategies ◽  
Stage 1

Ovarian Cancer is a problem battled worldwide and is typically diagnosed at an advanced stage due to the lack of effective screening strategies. An effective screening method should detect the disease at an earlier stage at diagnosis such that treatment would result in better outcome and not the inevitable mortality. Diagnosis of Ovarian cancer at an early stage (stage 1) could be a benefit of good screening strategies because it is associated with a high 5- year survival rate (95%) as it appears that globally, there is no early detection for this yet. In this article, we review the epidemiology, risk factors as well as the current state of screening tests for ovarian cancer in Nigeria.

scholarly journals The Association of Hypertension With the Severity of and Mortality From the COVID-19 in the Early Stage of the Epidemic in Wuhan, China: A Multicenter Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Sumaira Mubarik ◽  
Xiaoxue Liu ◽  
Ehab S. Eshak ◽  
Keyang Liu ◽  
Qing Liu ◽  
...  
Keyword(s):  
Survival Time ◽  
Disease Severity ◽  
Median Survival ◽  
Median Survival Time ◽  
Early Stage ◽  
Hypertension Status ◽  
Factors Associated ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Before And After

Background: Hypertension may affect the prognosis of COVID-19 illness. We analyzed the epidemiological and clinical characteristics associated with the disease severity and mortality in hypertensive vs. non-hypertensive deceased COVID-19 patients.Methods: We included all the deceased patients with laboratory-confirmed COVID-19 admitted to &gt;200 health facilities in Wuhan between December 1 and February 24, 2020. The median survival time in COVID-19 patients with and without hypertension, the association of hypertension with the disease severity, and the risk factors associated with the COVID-19 mortality stratified by the hypertension status were assessed using the Kaplan-Meier survival analysis, logistic regression, and Cox proportional regression, respectively before and after the propensity score-matching (PS) for age and sex.Results: The prevalence of hypertension in the studied 1,833 COVID-19 patients was 40.5%. Patients with hypertension were more likely to have severe COVID-19 illness than patients without hypertension; the PS-matched multivariable-adjusted odds ratio (95% CI) was 2.44 (1.77–3.08). Moreover, the median survival time in the hypertension group was 3–5 days shorter than the non-hypertension group. There was a 2-fold increased risk of COVID-19 mortality in the hypertension group compared with the non-hypertension group; the PS-matched multivariable-adjusted hazard ratio (HR) = 2.04 (1.61–2.72), and the significant increased risk of COVID-19 mortality in the moderate vs. mild COVID-19 illness was confined to patients with hypertension. Additionally, the history and the number of underlying chronic diseases, occupation, and residential location showed stronger associations with the COVID-19 mortality among patients with hypertension than patients without hypertension.Conclusion: Hypertension was associated with the severity and mortality of COVID-19 illness.

scholarly journals The effect of marital status on stage at diagnosis and survival in Saudis diagnosed with colorectal cancer: cancer registry analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mesnad Alyabsi ◽  
Majed Ramadan ◽  
Mohammed Algarni ◽  
Kanan Alshammari ◽  
Abdul Rahman Jazieh
Keyword(s):  
Colorectal Cancer ◽  
Marital Status ◽  
Cancer Registry ◽  
National Guard ◽  
Early Stage ◽  
Stage At Diagnosis ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Registry Analysis

AbstractColorectal cancer (CRC) is the most common cancer in males and third in females in Saudi Arabia, with the majority (66%) diagnosed at a late stage. We evaluated the effect of marital status on stage at diagnosis and CRC survival. We hypothesized that married patients would be more likely to present at an early stage and have higher survival than unmarried patients. The Ministry of National Guard-Health Affairs (MNG-HA) cancer registry was used to identify patients diagnosed with CRC from 2009 to 2017. A competing risk analysis was performed to assess the 5-year CRC-specific survival, adjusting for potential confounders. The Kaplan–Meier method and the Cox regressions were used to assess survival. Two-thirds (76.50%) of the 936 CRC patients were married, 11.64% were unmarried, and 11.86% had an unknown marital status. With multiple imputation-based analysis, the multivariate analysis indicated that unmarried patients were 52% more likely to present at an advanced stage [adjusted odds ratio (aOR) 1.52; 95% CI 1.33–1.73], and had a 30% higher risk of death due to CRC compared to the married patients (aHR 1.30; CI 1.17, 1.44). Future CRC screening and survivorship programs should assess the needs of the vulnerable unmarried population. Interventions supporting the early detection of CRC in this population may be beneficial in the long term and lead to improved cancer outcomes.

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