title: Improved 5-year survival of patients with immunochemical faecal blood test-screen-detected colorectal cancer versus non-screening cancers in northern Italy.
abstract: BACKGROUND
  Colorectal cancer screening may reduce disease-related mortality by early-stage detection of cancers.
  
  
  OBJECTIVE
  To study the effect of a single immunochemical faecal occult blood test (i-FOBt) screening round on reduction in colorectal cancer-related-mortality among average risk subjects.
  
  
  METHODS
  Comparison of 5-year mortality rates in 3 cohorts from a Northern Italian province: (1) colorectal cancers detected at the 1st biennial round of a mass-screening programme targeting 50-69 years old subjects, (2) non-screening cancers symptomatically diagnosed during the same time period, and (3) cancers detected in the pre-screening biennium. Multivariate analyses were performed with the Cox regression model including tumour node metastasis (TNM) stage at diagnosis, anatomical distribution of cancers, age at diagnosis, gender and patient group. Kaplan-Meyer survival estimates and log-rank test for equality of survivor functions were calculated.
  
  
  RESULTS
  Stage distribution significantly differed between screening and non-screening colorectal cancers: 73% of screen-detected colorectal cancers were stages I and II versus 43% and 40% of non-screening and pre-screening colorectal cancers. Cumulative 5-year mortality rate was significantly lower in screening compared to non-screening or pre-screening colorectal cancers patients (19% versus 37% and 41%, p < 0.001).
  
  
  CONCLUSIONS
  Colorectal cancers were detected at earlier stages in i-FOBT-positive subjects in comparison with non-screening patients; colorectal cancers found at screening had a significantly improved 5-year survival.
authors.affiliation: Gastroenterology Department, A. Manzoni Hospital, Lecco, Italy. Electronic address: f.parente@ospedale.lecco.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Parente
authors.affiliation: Gastroenterology Department, A. Manzoni Hospital, Lecco, Italy.
authors.forename: Cristian
authors.initials: C
authors.lastname: Vailati
authors.affiliation: Gastroenterology Department, A. Manzoni Hospital, Lecco, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Boemo
authors.affiliation: Pathology Department, A. Manzoni Hospital, Lecco, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Bonoldi
authors.affiliation: Oncology Department, A. Manzoni Hospital, Lecco, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ardizzoia
authors.affiliation: Preventive Medicine, Local Health Care Centre Lecco, Italy.
authors.forename: Antonina
authors.initials: A
authors.lastname: Ilardo
authors.affiliation: Preventive Medicine, Local Health Care Centre Lecco, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Tortorella
authors.affiliation: Screening Unit, Regional Health Centre Milan, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Cereda
authors.affiliation: Epidemiology, Local Health Care Centre, Bergamo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cremaschini
authors.affiliation: Epidemiology, Local Health Care Centre, Bergamo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Moretti
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007120:Immunochemistry; D007558:Italy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009780:Occult Blood; D016016:Proportional Hazards Models; D012042:Registries
keywords: Colorectal cancer; Early detection of cancer; Immunochemical FOBt; Mass screening