Colorectal Cancer Screening Outcomes of 2412 Prostate Cancer Patients Considered for Carbon Ion Radiotherapy.

Nao Kobayashi,Hiro Sato,Tatsuji Mizukami,Tatsuya Ohno,Akiko Adachi,Nobuteru Kubo,Hidemasa Kawamura,Yuhei Miyasaka,Hiroyuki Katoh,Takahiro Oike

doi:10.3390/cancers13174481

Abstract

Simple SummaryColorectal cancer (CRC) screening is effective for cancer detection in average-risk adults. For prostate cancer (PCa) patients considered for carbon ion radiotherapy (CIRT), pre-treatment CRC screening is performed empirically to avoid post-treatment colonoscopic manipulation. However, the outcomes of screening remain unclear. To address this, we analyzed the outcomes of 2412 PCa patients at average risk for CRC who underwent routine pre-CIRT CRC screening and found that the estimated CRC prevalence was greater than that reported by 17 previous large-scale screening studies analyzing average-risk adults. These data indicate the possibility that the prevalence of CRC in PCa patients is greater than that in general average-risk adults, warranting further research.Colorectal cancer (CRC) screening is effective for detecting cancer in average-risk adults. For prostate cancer (PCa) patients considered for carbon ion radiotherapy (CIRT), pre-treatment CRC screening is performed empirically to avoid post-treatment colonoscopic manipulation. However, the outcomes of screening this population remain unclear. Here, we compared the outcomes of routine pre-CIRT CRC screening of 2412 PCa patients at average risk for CRC with data from two published datasets: the Japan National Cancer Registry (JNCR) and a series of 17 large-scale screening studies analyzing average-risk adults. The estimated prevalence rate was calculated using the pooled sensitivity elucidated by a previous meta-analysis. Consequently, 28 patients (1.16%) were diagnosed with CRC. CRC morbidity was significantly associated with high pre-treatment levels of prostate-specific antigen (p = 0.023). The screening positivity rate in this study cohort exceeded the annual incidence reported in the JNCR for most age brackets. Furthermore, the estimated prevalence rate in this study cohort (1.46%) exceeded that reported in all 17 large-scale studies, making the result an outlier (p = 0.005). These data indicate the possibility that the prevalence of CRC in PCa patients is greater than that in general average-risk adults, warranting further research in a prospective setting.

Highlights

Introduction distributed under the terms andColorectal cancer (CRC) and prostate cancer (PCa) are the third and fifth leading causes of death, respectively, among all cancers in men worldwide [1]
It is preferrable that patients with PCa who are considered for carbon ion radiotherapy (CIRT) receive CRC screening prior to treatment
We found that the prevalence of CRC in PCa patients referred to GHMC for purpose of CIRT was greater than that in the general population

Summary

Introduction

Colorectal cancer (CRC) and prostate cancer (PCa) are the third and fifth leading causes of death, respectively, among all cancers in men worldwide [1]. For localized PCa, radiation therapy is the standard treatment [2]; carbon ion radiotherapy (CIRT). PCa treated with CIRT [4], and subsequent colonoscopic manipulation of the irradiated site can exacerbate this rectal condition [5]. It is preferrable that patients with PCa who are considered for CIRT receive CRC screening prior to treatment. From this perspective, CRC screening is routine practice for PCa patients on their first referral to our CIRT center

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