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Screen-detected and interval colorectal cancers in England: Associations with lifestyle and other factors in women in a large UK prospective cohort.

Authors
  • Blanks, Roger1
  • Burón Pust, Andrea2, 3, 4
  • Alison, Rupert1
  • He, Emily5
  • Barnes, Isobel1
  • Patnick, Julietta1
  • Reeves, Gillian K1
  • Floud, Sarah1
  • Beral, Valerie1
  • Green, Jane1
  • 1 Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Headington, Oxford, United Kingdom. , (United Kingdom)
  • 2 Department of Epidemiology and Evaluation, Hospital del Mar, Barcelona, Spain. , (Spain)
  • 3 IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. , (Spain)
  • 4 REDISSEC, Health Services Research on Chronic Patients Network, Madrid, Spain. , (Spain)
  • 5 Prince of Wales Clinical School, UNSW Australia, Sydney, NSW, Australia. , (Australia)
Type
Published Article
Journal
International Journal of Cancer
Publisher
Wiley (John Wiley & Sons)
Publication Date
Aug 01, 2019
Volume
145
Issue
3
Pages
728–734
Identifiers
DOI: 10.1002/ijc.32168
PMID: 30694563
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Faecal occult blood (FOB) - based screening programmes for colorectal cancer detect about half of all cancers. Little is known about individual health behavioural characteristics which may be associated with screen-detected and interval cancers. Electronic linkage between the UK National Health Service Bowel Cancer Screening Programme (BCSP) in England, cancer registration and other national health records, and a large on-going UK cohort, the Million Women Study, provided data on 628,976 women screened using a guaiac-FOB test (gFOBt) between 2006 and 2012. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated by logistic and Cox regression for associations between individual lifestyle factors and risk of colorectal tumours. Among screened women, 766 were diagnosed with screen-detected colorectal cancer registered within 2 years after a positive gFOBt result, and 749 with interval colorectal cancers registered within 2 years after a negative gFOBt result. Current smoking was significantly associated with risk of interval cancer (RR 1.64, 95%CI 1.35-1.99) but not with risk of screen-detected cancer (RR 1.03, 0.84-1.28), and was the only factor of eight examined to show a significant difference in risk between interval and screen-detected cancers (p for difference, 0.003). Compared to screen-detected cancers, interval cancers tended to be sited in the proximal colon or rectum, to be of non-adenocarcinoma morphology, and to be of higher stage. © 2019 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

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