Original articleClinical endoscopySurvival in patients with colorectal cancer diagnosed by screening colonoscopy

BackgroundIn Germany, screening colonoscopy was first established in 2002 as part of the national cancer screening program.ObjectiveTo evaluate whether colorectal cancer (CRC) survival differs when CRC is diagnosed by screening colonoscopy (S-CRC) versus diagnostic colonoscopy (D-CRC).DesignLong-term, retrospective, multicenter, observational study.SettingStudy centers: 10 private gastroenterology practices in Germany.PatientsA total of 60 patients diagnosed with CRC during screening colonoscopy and 252 patients during diagnostic colonoscopy in 2002, 2003, and 2004.InterventionsColonoscopy.Main Outcome MeasurementsSurvival of patients up to December 2013.ResultsMean (± standard deviation [SD]) follow-up time was 81.0 (± 40.1) months. Union Internationale Contre le Cancer (UICC) stages I and II were found more often in S-CRC (81.6%) compared with D-CRC (59.9%; P < .002). Kaplan-Meier analysis showed significantly reduced overall survival for patients with D-CRC (mean [± SD] 86.9 [± 3.0] months; 95% confidence interval [CI], 81.0-92.8) compared with S-CRC (mean [± SD] 107.1 [± 4.9] months; 95% CI, 97.4-116.9; P = .003). When deaths not related to CRC were excluded, survival was still shorter for D-CRC patients (mean [± SD] 89.4 [± 3.0] months; 95% CI, 83.5-95.4) compared with S-CRC (mean [± SD] 109.6 [± 4.7] months; 95% CI, 100.2-119.0; P = .004).LimitationsRetrospective study design.ConclusionIn this long-term, retrospective study, patients with CRC diagnosed during screening colonoscopy lived significantly longer when compared with patients with CRC diagnosed during diagnostic colonoscopy.