The lifelong risk of metachronous colorectal cancer justifies long-term colonoscopic follow-up

Fiche publication


Date publication

mars 2008

Auteurs

Membres identifiés du Cancéropôle Est :
Dr BOUVIER Anne-Marie, Dr JOOSTE Valérie, Pr LEPAGE Côme, Dr COTTET Vanessa


Tous les auteurs :
Bouvier AM, Latournerie M, Jooste V, Lepage C, Cottet V, Faivre J

Résumé

Background: The aim of this study was to calculate the risk of metachronous colorectal cancers, to specify their characteristics and potential risk factors in a well-defined French population over a 27-year period. Patients and methods: The 10,801 patients who had colorectal cancers totalled 61,879 person-years of follow-up. The actuarial method was used to obtain crude metachronous colorectal cancer rates. Standardised incidence ratios (SIRs) were calculated. Results: The cumulative rate of metachronous colorectal cancer was 1.8% at 5 years, 3.4% at 10 years and 7.2% at 20 years. The incidence of metachronous colorectal cancer following a first colorectal cancer was higher than expected (SIR: 1.5 [1.3-1.7] p < 0.001). It remained greater throughout the study period, significantly only between the first and the fifth years following diagnosis (SIR: 1.9 [1.6-2.3] p < 0.010). As compared to solitary cancers, metachronous cancers were diagnosed at earlier stages (23.5% versus 40.9% were stage 1, p < 0.001). None of the personal and tumour characteristics were predicting factors for the development of metachronous colorectal cancer. Conclusion: Patients with colorectal cancer are at greater risk of developing a metachronous colorectal cancer. Among them, no predicting factors for the development of metachronous tumours were found. Thus lifelong colonoscopic surveillance is needed. (c) 2008 Elsevier Ltd. All rights reserved.

Référence

Eur J Cancer. 2008 Mar;44(4):522-7