Differences in treatment of stage I colorectal cancers: a population-based study of colorectal cancers detected within and outside of a screening program.
Esther Toes-ZoutenkijkEmilie C H BreekveldtLisa van der ScheeIris D NagtegaalMarloes A G ElferinkIris Lansdorp-VogelaarLeon M G MoonsMonique E van LeerdamPublished in: Endoscopy (2023)
< 0.001). When only T1 tumors were considered, both screen-detected colon and rectal cancers were more often treated with local excision only than non-screen-detected T1 cancers (odds ratio [OR] 2.19, 95 %CI 1.93-2.49; and OR 1.29, 95 %CI 1.05-1.59, respectively), adjusted for sex, tumor location, lymphovascular invasion (LVI) status, and tumor differentiation. CONCLUSIONS : Less invasive treatment of screen-detected stage I CRC is partly explained by the higher rate of T1 cancers compared with non-screen-detected stage I CRCs. T1 stage I screen-detected CRCs were also more likely to undergo less invasive treatment than non-screen-detected CRCs, adjusted for risk factors such as LVI and tumor differentiation. Future research should investigate whether the choice of local excision was related to unidentified cancer-related factors or the expertise of the endoscopists.