B-PO02-147 IMPACT OF ORAL ANTICOAGULATION THERAPY ON COLORECTAL CANCER DIAGNOSIS

Abstract

Oral anticoagulation therapy (AC) is associated with an increased risk of gastrointestinal (GI) bleeding which is frequently the presenting symptom of colorectal cancer (CRC). There is currently no evidence that AC is associated with an earlier diagnosis of CRC. We sought to investigate if GI bleeding on AC leads to earlier diagnosis of CRC. We retrospectively reviewed pathology findings from 417 patients with CRC undergoing tumor resection. Data was analyzed by tumor greatest dimension, histopathology grade and TNM system. Data was then compared by AC and anti-platelet therapy (AP) use at the time of tumor resection. At time of diagnosis, 27 patients were on AC (6.5%, DOAC n=20, Warfarin n=7) and 390 patients were not. Patients on AC had smaller tumor size (3.3 ± 1.3 cm) vs. those not on AC (4.3 ± 2.7cm, p= 0.02). Of 27 patients on AC, only 2 (8%) were diagnosed ≥ tumor stage 4 compared to 72/374 patients not on AC (19%, p= 0.125). Distant metastasis was found in 5/27 patients (19%) on AC vs. 122/388 patients not on AC (31%, p=0.4). AP therapy was not associated with a decrease in tumor size or stage at diagnosis. AC use was associated with smaller tumor size at the time of diagnosis with a trend toward less advanced tumor stage. Earlier diagnosis of CRC may lead to earlier treatment and improved mortality. Further studies are needed to determine whether AC use is associated with lower mortality in this patient population.