title: Survival in patients with colorectal cancer diagnosed by screening colonoscopy.
abstract: BACKGROUND
  In Germany, screening colonoscopy was first established in 2002 as part of the national cancer screening program.
  
  
  OBJECTIVE
  To evaluate whether colorectal cancer (CRC) survival differs when CRC is diagnosed by screening colonoscopy (S-CRC) versus diagnostic colonoscopy (D-CRC).
  
  
  METHODS
  Long-term, retrospective, multicenter, observational study.
  
  
  METHODS
  Study centers: 10 private gastroenterology practices in Germany.
  
  
  METHODS
  A total of 60 patients diagnosed with CRC during screening colonoscopy and 252 patients during diagnostic colonoscopy in 2002, 2003, and 2004.
  
  
  METHODS
  Colonoscopy.
  
  
  METHODS
  Survival of patients up to December 2013.
  
  
  RESULTS
  Mean (± standard deviation [SD]) follow-up time was 81.0 (± 40.1) months. Union Internationale Contre le Cancer (UICC) stages I and II were found more often in S-CRC (81.6%) compared with D-CRC (59.9%; P < .002). Kaplan-Meier analysis showed significantly reduced overall survival for patients with D-CRC (mean [± SD] 86.9 [± 3.0] months; 95% confidence interval [CI], 81.0-92.8) compared with S-CRC (mean [± SD] 107.1 [± 4.9] months; 95% CI, 97.4-116.9; P = .003). When deaths not related to CRC were excluded, survival was still shorter for D-CRC patients (mean [± SD] 89.4 [± 3.0] months; 95% CI, 83.5-95.4) compared with S-CRC (mean [± SD] 109.6 [± 4.7] months; 95% CI, 100.2-119.0; P = .004).
  
  
  CONCLUSIONS
  Retrospective study design.
  
  
  CONCLUSIONS
  In this long-term, retrospective study, patients with CRC diagnosed during screening colonoscopy lived significantly longer when compared with patients with CRC diagnosed during diagnostic colonoscopy.
authors.affiliation: Department of Gastroenterology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: Kilian
authors.initials: K
authors.lastname: Friedrich
authors.affiliation: Department of Gastroenterology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Grüter
authors.affiliation: Department of Gastroenterology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gotthardt
authors.affiliation: Department of Gastroenterology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Eisenbach
authors.affiliation: Department of Gastroenterology, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stremmel
authors.affiliation: Department of Social Psychology, University of Mannheim, Mannheim, Germany.
authors.forename: Sabine G
authors.initials: SG
authors.lastname: Scholl
authors.affiliation: Department of Gastroenterology, Indiana University Hospital, Indianapolis, Indiana, USA.
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Rex
authors.affiliation: Department of Gastroenterology, University Hospital of Heidelberg, Heidelberg, Germany; Practice of Gastroenterology, Heidelberg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Sieg
mesh_terms: D000328:Adult; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality*; D055088:Early Detection of Cancer; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate