- Gastrointestinal cancer
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Colonoscopic Screening and Risk of All-Cause and Colorectal Cancer Mortality in Young and Older Individuals
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Jung Ah Lee, Yoosoo Chang, Yejin Kim, Dong-Il Park, Soo-Kyung Park, Hye Yin Park, Jaewoo Koh, Soo-Jin Lee, Seungho Ryu
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Cancer Res Treat. 2023;55(2):618-625. Published online September 19, 2022
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DOI: https://doi.org/10.4143/crt.2022.852
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 Abstract
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- Purpose
The incidence of early-onset colorectal cancer (CRC) and associated mortality have been increasing. However, the potential benefits of CRC screening are largely unknown in young individuals. We aimed to evaluate the effect of CRC screening with colonoscopy on all-cause and CRC mortality among young (aged < 45 years) and older (aged ≥ 45 years) individuals.
Materials and Methods
This cohort study included 528,046 Korean adults free of cancer at baseline who underwent a comprehensive health examination. The colonoscopic screening group was defined as those who reported undergoing colonoscopy for CRC screening. Mortality follow-up until December 31, 2019 was ascertained based on nationwide death certificate data from the Korea National Statistical Office.
Results
Colonoscopic screening was associated with a lower risk of all-cause mortality in both young and older individuals. Multivariable-adjusted time-dependent hazard ratios (95% confidence intervals) for all-cause mortality comparing ever- to never-screening were 0.86 (0.75-0.99) for young individuals and 0.71 (0.65-0.78) for older individuals. Colonoscopic screenings were also associated with a reduced risk of CRC mortality without significant interaction by age, although this association was significant only among participants aged ≥ 45 years, with corresponding time-dependent hazard ratios of 0.47 (0.15-1.44) for young individuals and 0.52 (0.31-0.87) for those aged ≥ 45 years.
Conclusion
Colonoscopic CRC screening decreased all-cause mortality among both young and older individuals, while significantly decreased CRC mortality was observed only in those aged ≥ 45 years. Screening initiation at an earlier age warrants more rigorous confirmatory studies.
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Citations
Citations to this article as recorded by  - Effect of screening mammography on the risk of breast cancer deaths and of all-cause deaths: a systematic review with meta-analysis of cohort studies
Philippe Autier, Karsten Juhl Jørgensen, Michel Smans, Henrik Støvring
Journal of Clinical Epidemiology.2024; 172: 111426. CrossRef - Identifying Gaps in Early-Onset Colorectal Cancer Prevention, Screening, and Treatment in the Philippines
Luis Miguel B. Co, Robyn Gayle K. Dychiao, Michael Paolo R. Capistrano, Manolito T. Tayag, Erika P. Ong, Frances Dominique V. Ho, Michelle Ann B. Eala, Henri Cartier Co, Edward Christopher Dee, Marie Dione P. Sacdalan, Dennis L. Sacdalan
Annals of Surgical Oncology.2024; 31(12): 7685. CrossRef - Rising incidence and impact of early‐onset colorectal cancer in the Asia‐Pacific with higher mortality in females from Southeast Asia: a global burden analysis from 2010 to 2019
Pojsakorn Danpanichkul, Pinyada Moolkaew, Yatawee Kanjanakot, Natchaya Polpichai, Aunchalee Jaroenlapnopparat, Donghee Kim, Frank J. Lukens, Wahid Wassef, Michael B. Fallon, Vincent L. Chen, Rashid Lui, Karn Wijarnpreecha
Journal of Gastroenterology and Hepatology.2023; 38(12): 2053. CrossRef
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