Biological and prognostic differences between symptomatic colorectal carcinomas and those detected by screening

• Published in: European journal of surgical oncology Vol. 45; no. 10; pp. 1876 - 1881
• Main Authors: Téllez, Teresa, Abitei, Cristina, Padilla-Ruiz, María del Carmen, Rivas-Ruiz, Francisco, Fúnez, Rafael, Pereda, Teresa, Rodrigo, Isabel, Alcaide, Julia, Baré, María Luisa, Morales Suárez-Varela, María Manuela, Zabalza, Iñaki, Sánchez del Charco, Matilde, Borrero Martín, Juan José, García del Moral, Raimundo, Escobar, Antonio, Quintana, José María, Aguirre, Urko, Redondo, Maximino, Quintana Lopez, José María, Mañas, Marisa Baré, Bautista, Maximino Redondo, Pérez de la Blanca, Eduardo Briones, Fernández de Larrea Baz, Nerea, Eizaguirre, Cristina Sarasqueta, Martínez, Antonio Escobar, Ruiz, Francisco Rivas, Morales-Suárez-Varela, María M., Blasco Amaro, Juan Antonio, Gonzalez, Isabel del Cura, Madariaga, Inmaculada Arostegui, González, Amaia Bilbao, Hernandez, Nerea González, García-Gutiérrez, Susana, Guerrero, Iratxe Lafuente, Larracoechea, Urko Aguirre, Calzada, Miren Orive, Corral, Josune Martin, Anton-Ladislao, Ane, Torà, Nuria, Pont, Marina, Martínez del Prado, María Purificación, Totorikaguena, Alberto Loizate, Estevez, Ignacio Zabalza, Alustiza, José Errasti, Gimeno García, Antonio Z., Aramburu, Santiago Lázaro, Serrano, Mercè Comas, Enríquez Navascues, José María, Galan, Carlos Placer, Perales, Amaia, Valmaña, Iñaki Urkidi, Erro Azkárate, José María, Lizarribar, Enrique Cormenzana, Muñoa, Adelaida Lacasta, Pibernat, Pep Piera, Cuevas, Elena Campano, Sotelo Gómez, Ana Isabel, Abril, Segundo Gómez, Medina-Cano, F., Del Rey-Moreno, Arturo, Alcántara, Manuel Jesús, Campo, Rafael, Casalots, Alex, Pericay, Carles, Gil, María José, Pera, Miquel, Collera, Pablo, Espinàs, Josep Alfons, Martínez, Mercedes, Espallargues, Mireia, Almazán, Caridad, Lindenbaum, Paula Dujovne, Fernández-Cebrián, José María, Fernández, Rocío Anula, Mayol Martínez, Julio Ángel, Cid, Ramón Cantero, Labajo, Héctor Guadalajara, Garceau, María Heras, Olmo, Damián García, Montalvo, Mariel Morey, Mar, Javier
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-10-2019
• Subjects: Biological markers; Colorectal carcinomas; Screening; Survival; Screening; Biological markers; Survival; Colorectal carcinomas
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2019.05.027

Few studies have been conducted to establish the relationship between colorectal cancer screening programmes and survival adjusting by stage and, to determine whether there are differences, at a biological level, between the tumours of asymptomatic and symptomatic patients.
Accordingly, the aim of this study is to evaluate clinical, biological and survival differences between symptomatic colorectal tumours and those detected by screening.
A prospective cohort study was performed of patients subjected to surgical intervention during the period 2010–2012, at different hospitals in Spain. In every case, clinical, pathological, biological and survival-related variables were obtained.
A total of 2634 patients from the CARESS-CCR cohort were analysed; of these, 220 were diagnosed through screening. The asymptomatic patients were younger, had a higher Body Mass Index (BMI), a lower degree of perineural invasion and a less advanced T stage and nodular stage, and the tumour was frequently located on the right side of the colon. All of these differences were statistically significant. The serum tumour marker carbohydrate antigen 19.9 (CA 19.9) was found more frequently in the symptomatic patients (p < 0.05). However, no significant differences were found regarding the markers of tumour biology: Ki67 (proliferation), CD105 (angiogenesis) and the Terminal deoxynucleotidyl transferase (TdT) dUTP Nick-End Labeling (TUNEL) assay (apoptosis). The patients with asymptomatic tumours had a lower mortality at five years than those diagnosed presenting symptoms.
The detection method employed influenced the survival of patients with colorectal cancer and there were no significant biological differences between the study groups.