Clinical Edge

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Failures in the CRC Screening Process & Risk of Death

Gastroenterology; ePub 2018 Sep 27; Doubeni, et al

Patients who are up-to-date on colorectal cancer (CRC) screening have a substantially reduced risk of CRC death, a recent study found. Researchers performed a retrospective cohort study of patients in the Kaiser Permanente Northern and Southern California systems aged 55-90 years who died from CRC from 2006 through 2012 and had ≥5 years of enrollment prior to diagnosis. They compared data from patients with a matched cohort of cancer-free patients in the same system. Among the findings:

  • Among 1,750 CRC deaths, nearly 76% (n=1,328) occurred in patients who were not up-to-date in screening and 24.1% (n=422) occurred in patients who were up-to-date.
  • Most patients who died from CRC had failures in the screening process that could be rectified.
  • CRC death was associated with higher odds of failure to screen or failure to screen at appropriate intervals (odds ratio [OR], 2.40) and failure to follow-up on abnormal results (OR, 7,26).


Doubeni CA, Fedewa SA, Levin TR, et al. Modifiable failures in the colorectal cancer screening process and their association with risk of death. [Published online ahead of print September 27, 2018]. Gastroenterology. doi:10.1053/j.gastro.2018.09.040.