Early-onset colorectal cancer patients do not require shorter intervals for post-surgical surveillance colonoscopy Journal Article
| Authors: | Mendelsohn, R. B.; Hahn, A. I.; Palmaira, R. L.; Saxena, A. R.; Mukthinuthalapati, P. K.; Schattner, M. A.; Markowitz, A. J.; Ludwig, E.; Shah, P.; Calo, D.; Gerdes, H.; Yaeger, R.; Stadler, Z.; Zauber, A. G.; Cercek, A. |
| Article Title: | Early-onset colorectal cancer patients do not require shorter intervals for post-surgical surveillance colonoscopy |
| Abstract: | Background & Aims: Early-onset colorectal cancer (EO-CRC), diagnosed before age 50, is rising in incidence worldwide. Although post-surgical colonoscopy surveillance strategies exist, appropriate intervals in EO-CRC remain elusive, as long-term surveillance outcomes remain scant. We sought to compare findings of surveillance colonoscopies of EO-CRC with patients with average onset colorectal cancer (AO-CRC) to help define surveillance outcomes in these groups. Methods: Single-institution retrospective chart review identified EO-CRC and AO-CRC patients with colonoscopy and no evidence of disease. Surveillance intervals and time to development of advanced neoplasia (CRC and advanced polyps [adenoma/sessile serrated]) were examined. For each group, 3 serial surveillance colonoscopies were evaluated. Statistical analyses were performed utilizing log-ranked Kaplan-Meier method and Cox proportional hazards. Results: A total of 1259 patients with CRC were identified, with 612 and 647 patients in the EO-CRC and AO-CRC groups, respectively. Compared with patients with AO-CRC, patients with EO-CRC had a 29% decreased risk of developing advanced neoplasia from time of initial surgery to first surveillance colonoscopy (hazard ratio, 0.71; 95% confidence interval, 0.52–1.0). Average follow-up time from surgical resection to first surveillance colonoscopy was 12.6 months for both cohorts. Overall surveillance findings differed between cohorts (P = .003), and patients with EO-CRC were found to have less advanced neoplasia compared with their counterparts with AO-CRC (12.4% vs 16.0%, respectively). Subsequent colonoscopies found that, while patients with EO-CRC returned for follow-up surveillance colonoscopy earlier than patients with AO-CRC, the EO-CRC cohort did not have more advanced neoplasia nor non-advanced adenomas. Conclusions: Patients with EO-CRC do not have an increased risk of advanced neoplasia compared with patients with AO-CRC and therefore do not require more frequent colonoscopy surveillance than current guidelines recommend. © 2024 AGA Institute |
| Keywords: | adult; middle aged; cancer surgery; major clinical study; overall survival; fatigue; cancer recurrence; advanced cancer; cancer patient; cancer staging; follow up; cancer grading; colorectal cancer; incidence; cohort analysis; obesity; practice guideline; medical record review; retrospective study; risk factor; body mass; proportional hazards model; adenoma; colonoscopy; colon cancer; microsatellite instability; recurrent disease; health care system; ulcerative colitis; hazard ratio; kaplan meier method; rectum cancer; adenomatous polyp; race; underweight; surveillance; hereditary nonpolyposis colorectal cancer; disease surveillance; information; neoplasia; sessile serrated adenoma; human; male; female; article; splenic flexure; early-onset colorectal cancer; postoperative monitoring |
| Journal Title: | Clinical Gastroenterology and Hepatology |
| Volume: | 22 |
| Issue: | 12 |
| ISSN: | 1542-3565 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2024-12-01 |
| Start Page: | 2517 |
| End Page: | 2525.e3 |
| Language: | English |
| DOI: | 10.1016/j.cgh.2024.04.029 |
| PUBMED: | 38729386 |
| PROVIDER: | scopus |
| PMCID: | PMC11549250 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Robin Mendelsohn -- Source: Scopus |
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