Colorectal Cancer Initial Diagnosis

Screening Colonoscopy, Diagnostic Colonoscopy, or Emergent Surgery, and Tumor Stage and Size at Initial Presentation

Courtney C. Moreno, Pardeep Kumar Mittal, Patrick S. Sullivan, Robin Rutherford, Charles A. Staley, Kenneth Cardona, Natalyn N. Hawk, W. Thomas Dixon, Hiroumi D. Kitajima, Jian Kang, William C. Small, John Oshinski, John R. Votaw

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Introduction/Background Rates of colorectal cancer screening are improving but remain suboptimal. Limited information is available regarding how patients are diagnosed with colorectal cancer (for example, asymptomatic screened patients or diagnostic workup because of the presence of symptoms). The purpose of this investigation was to determine how patients were diagnosed with colorectal cancer (screening colonoscopy, diagnostic colonoscopy, or emergent surgery) and tumor stage and size at diagnosis. Patients and Methods Adults evaluated between 2011 and 2014 with a diagnosis of colorectal cancer were identified. Clinical notes, endoscopy reports, surgical reports, radiology reports, and pathology reports were reviewed. Sex, race, ethnicity, age at the time of initial diagnosis, method of diagnosis, presenting symptom(s), and primary tumor size and stage at diagnosis were recorded. Colorectal cancer screening history was also recorded. Results The study population was 54% male (265 of 492) with a mean age of 58.9 years (range, 25-93 years). Initial tissue diagnosis was established at the time of screening colonoscopy in 10.7%, diagnostic colonoscopy in 79.2%, and during emergent surgery in 7.1%. Cancers diagnosed at the time of screening colonoscopy were more likely to be stage 1 than cancers diagnosed at the time of diagnostic colonoscopy or emergent surgery (38.5%, 7.2%, and 0%, respectively). Median tumor size was 3.0 cm for the screening colonoscopy group, 4.6 cm for the diagnostic colonoscopy group, and 5.0 cm for the emergent surgery group. At least 31% of patients diagnosed at the time of screening colonoscopy, 19% of patients diagnosed at the time of diagnostic colonoscopy, and 26% of patients diagnosed at the time of emergent surgery had never undergone a screening colonoscopy. Conclusion Nearly 90% of colorectal cancer patients were diagnosed after development of symptoms and had more advanced disease than asymptomatic screening patients. Colorectal cancer outcomes will be improved by improving rates of colorectal cancer screening.

Original languageEnglish (US)
Pages (from-to)67-73
Number of pages7
JournalClinical Colorectal Cancer
Volume15
Issue number1
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

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Colonoscopy
Colorectal Neoplasms
Neoplasms
Early Detection of Cancer
Asymptomatic Diseases
Radiology
Endoscopy
History
Pathology

Keywords

  • Cancer detection
  • Colorectal cancer
  • Diagnostic colonoscopy
  • Screening colonoscopy
  • Screening compliance

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

Colorectal Cancer Initial Diagnosis : Screening Colonoscopy, Diagnostic Colonoscopy, or Emergent Surgery, and Tumor Stage and Size at Initial Presentation. / Moreno, Courtney C.; Mittal, Pardeep Kumar; Sullivan, Patrick S.; Rutherford, Robin; Staley, Charles A.; Cardona, Kenneth; Hawk, Natalyn N.; Dixon, W. Thomas; Kitajima, Hiroumi D.; Kang, Jian; Small, William C.; Oshinski, John; Votaw, John R.

In: Clinical Colorectal Cancer, Vol. 15, No. 1, 01.03.2016, p. 67-73.

Research output: Contribution to journalArticle

Moreno, CC, Mittal, PK, Sullivan, PS, Rutherford, R, Staley, CA, Cardona, K, Hawk, NN, Dixon, WT, Kitajima, HD, Kang, J, Small, WC, Oshinski, J & Votaw, JR 2016, 'Colorectal Cancer Initial Diagnosis: Screening Colonoscopy, Diagnostic Colonoscopy, or Emergent Surgery, and Tumor Stage and Size at Initial Presentation', Clinical Colorectal Cancer, vol. 15, no. 1, pp. 67-73. https://doi.org/10.1016/j.clcc.2015.07.004
Moreno, Courtney C. ; Mittal, Pardeep Kumar ; Sullivan, Patrick S. ; Rutherford, Robin ; Staley, Charles A. ; Cardona, Kenneth ; Hawk, Natalyn N. ; Dixon, W. Thomas ; Kitajima, Hiroumi D. ; Kang, Jian ; Small, William C. ; Oshinski, John ; Votaw, John R. / Colorectal Cancer Initial Diagnosis : Screening Colonoscopy, Diagnostic Colonoscopy, or Emergent Surgery, and Tumor Stage and Size at Initial Presentation. In: Clinical Colorectal Cancer. 2016 ; Vol. 15, No. 1. pp. 67-73.
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abstract = "Introduction/Background Rates of colorectal cancer screening are improving but remain suboptimal. Limited information is available regarding how patients are diagnosed with colorectal cancer (for example, asymptomatic screened patients or diagnostic workup because of the presence of symptoms). The purpose of this investigation was to determine how patients were diagnosed with colorectal cancer (screening colonoscopy, diagnostic colonoscopy, or emergent surgery) and tumor stage and size at diagnosis. Patients and Methods Adults evaluated between 2011 and 2014 with a diagnosis of colorectal cancer were identified. Clinical notes, endoscopy reports, surgical reports, radiology reports, and pathology reports were reviewed. Sex, race, ethnicity, age at the time of initial diagnosis, method of diagnosis, presenting symptom(s), and primary tumor size and stage at diagnosis were recorded. Colorectal cancer screening history was also recorded. Results The study population was 54{\%} male (265 of 492) with a mean age of 58.9 years (range, 25-93 years). Initial tissue diagnosis was established at the time of screening colonoscopy in 10.7{\%}, diagnostic colonoscopy in 79.2{\%}, and during emergent surgery in 7.1{\%}. Cancers diagnosed at the time of screening colonoscopy were more likely to be stage 1 than cancers diagnosed at the time of diagnostic colonoscopy or emergent surgery (38.5{\%}, 7.2{\%}, and 0{\%}, respectively). Median tumor size was 3.0 cm for the screening colonoscopy group, 4.6 cm for the diagnostic colonoscopy group, and 5.0 cm for the emergent surgery group. At least 31{\%} of patients diagnosed at the time of screening colonoscopy, 19{\%} of patients diagnosed at the time of diagnostic colonoscopy, and 26{\%} of patients diagnosed at the time of emergent surgery had never undergone a screening colonoscopy. Conclusion Nearly 90{\%} of colorectal cancer patients were diagnosed after development of symptoms and had more advanced disease than asymptomatic screening patients. Colorectal cancer outcomes will be improved by improving rates of colorectal cancer screening.",
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T2 - Screening Colonoscopy, Diagnostic Colonoscopy, or Emergent Surgery, and Tumor Stage and Size at Initial Presentation

AU - Moreno, Courtney C.

AU - Mittal, Pardeep Kumar

AU - Sullivan, Patrick S.

AU - Rutherford, Robin

AU - Staley, Charles A.

AU - Cardona, Kenneth

AU - Hawk, Natalyn N.

AU - Dixon, W. Thomas

AU - Kitajima, Hiroumi D.

AU - Kang, Jian

AU - Small, William C.

AU - Oshinski, John

AU - Votaw, John R.

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N2 - Introduction/Background Rates of colorectal cancer screening are improving but remain suboptimal. Limited information is available regarding how patients are diagnosed with colorectal cancer (for example, asymptomatic screened patients or diagnostic workup because of the presence of symptoms). The purpose of this investigation was to determine how patients were diagnosed with colorectal cancer (screening colonoscopy, diagnostic colonoscopy, or emergent surgery) and tumor stage and size at diagnosis. Patients and Methods Adults evaluated between 2011 and 2014 with a diagnosis of colorectal cancer were identified. Clinical notes, endoscopy reports, surgical reports, radiology reports, and pathology reports were reviewed. Sex, race, ethnicity, age at the time of initial diagnosis, method of diagnosis, presenting symptom(s), and primary tumor size and stage at diagnosis were recorded. Colorectal cancer screening history was also recorded. Results The study population was 54% male (265 of 492) with a mean age of 58.9 years (range, 25-93 years). Initial tissue diagnosis was established at the time of screening colonoscopy in 10.7%, diagnostic colonoscopy in 79.2%, and during emergent surgery in 7.1%. Cancers diagnosed at the time of screening colonoscopy were more likely to be stage 1 than cancers diagnosed at the time of diagnostic colonoscopy or emergent surgery (38.5%, 7.2%, and 0%, respectively). Median tumor size was 3.0 cm for the screening colonoscopy group, 4.6 cm for the diagnostic colonoscopy group, and 5.0 cm for the emergent surgery group. At least 31% of patients diagnosed at the time of screening colonoscopy, 19% of patients diagnosed at the time of diagnostic colonoscopy, and 26% of patients diagnosed at the time of emergent surgery had never undergone a screening colonoscopy. Conclusion Nearly 90% of colorectal cancer patients were diagnosed after development of symptoms and had more advanced disease than asymptomatic screening patients. Colorectal cancer outcomes will be improved by improving rates of colorectal cancer screening.

AB - Introduction/Background Rates of colorectal cancer screening are improving but remain suboptimal. Limited information is available regarding how patients are diagnosed with colorectal cancer (for example, asymptomatic screened patients or diagnostic workup because of the presence of symptoms). The purpose of this investigation was to determine how patients were diagnosed with colorectal cancer (screening colonoscopy, diagnostic colonoscopy, or emergent surgery) and tumor stage and size at diagnosis. Patients and Methods Adults evaluated between 2011 and 2014 with a diagnosis of colorectal cancer were identified. Clinical notes, endoscopy reports, surgical reports, radiology reports, and pathology reports were reviewed. Sex, race, ethnicity, age at the time of initial diagnosis, method of diagnosis, presenting symptom(s), and primary tumor size and stage at diagnosis were recorded. Colorectal cancer screening history was also recorded. Results The study population was 54% male (265 of 492) with a mean age of 58.9 years (range, 25-93 years). Initial tissue diagnosis was established at the time of screening colonoscopy in 10.7%, diagnostic colonoscopy in 79.2%, and during emergent surgery in 7.1%. Cancers diagnosed at the time of screening colonoscopy were more likely to be stage 1 than cancers diagnosed at the time of diagnostic colonoscopy or emergent surgery (38.5%, 7.2%, and 0%, respectively). Median tumor size was 3.0 cm for the screening colonoscopy group, 4.6 cm for the diagnostic colonoscopy group, and 5.0 cm for the emergent surgery group. At least 31% of patients diagnosed at the time of screening colonoscopy, 19% of patients diagnosed at the time of diagnostic colonoscopy, and 26% of patients diagnosed at the time of emergent surgery had never undergone a screening colonoscopy. Conclusion Nearly 90% of colorectal cancer patients were diagnosed after development of symptoms and had more advanced disease than asymptomatic screening patients. Colorectal cancer outcomes will be improved by improving rates of colorectal cancer screening.

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KW - Colorectal cancer

KW - Diagnostic colonoscopy

KW - Screening colonoscopy

KW - Screening compliance

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