Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2024; 30(10): 1368-1376
Published online Mar 14, 2024. doi: 10.3748/wjg.v30.i10.1368
Stage at diagnosis of colorectal cancer through diagnostic route: Who should be screened?
Nobukazu Agatsuma, Takahiro Utsumi, Yoshitaka Nishikawa, Takahiro Horimatsu, Takeshi Seta, Yukitaka Yamashita, Yukari Tanaka, Takahiro Inoue, Yuki Nakanishi, Takahiro Shimizu, Mikako Ohno, Akane Fukushima, Takeo Nakayama, Hiroshi Seno
Nobukazu Agatsuma, Takahiro Utsumi, Yukari Tanaka, Takahiro Inoue, Yuki Nakanishi, Takahiro Shimizu, Hiroshi Seno, Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
Nobukazu Agatsuma, Takeshi Seta, Yukitaka Yamashita, Department of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama 640-8558, Japan
Yoshitaka Nishikawa, Takeo Nakayama, Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan
Takahiro Horimatsu, Institute for Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital, Kyoto 606-8507, Japan
Mikako Ohno, Akane Fukushima, Medical Support Section, Medical Affairs Division, Kyoto University Hospital, Kyoto 606-8507, Japan
Author contributions: Agatsuma N, Utsumi T, Nishikawa Y, and Horimatsu T contributed to conception and design; Agatsuma N, Utsumi T, Nishikawa Y, Horimatsu T, Seta T, Yamashita Y, Tanaka Y, Inoue T, Nakanishi Y, Shimizu T, Ohno M, Fukushima A, Nakayama T, and Seno H contributed to data analysis and interpretation; Agatsuma N, Utsumi T, and Nishikawa Y contributed to manuscript drafting; Horimatsu T, Seta T, Yamashita Y, Tanaka Y, Inoue T, Nakanishi Y, Shimizu T, Ohno M, Fukushima A, Nakayama T, and Seno H contributed to critical article revision for important intellectual content; and all authors have read and agreed to the final version of the manuscript.
Supported by the Foundation for Cancer Research supported by Kyoto Preventive Medical Center and the Japan Society for the Promotion of Science (JSPS) Grants-in-Aid KAKENHI, No. JP 22K21080.
Institutional review board statement: The study protocol was approved by the Institutional Review Boards of Kyoto University Hospital (approval No. R3472), and the Japanese Red Cross Wakayama Medical Center (approval No. 1004).
Informed consent statement: Anonymized data were used in this study. The board approved an opt-out approach for the research use of the data. Information about the study’s purpose and data usage was posted on the hospital’s website rather than obtaining patient informed consent, ensuring patients’ right to withdraw.
Conflict-of-interest statement: Yoshitaka Nishikawa reports a donation from Datack outside the submitted work. Takeo Nakayama reports the following potential conflicts of interest outside the submitted work: Grants from I&H Co., Ltd, Cocokarafine Group Co., Ltd, Konica Minolta, Inc., and NTT DATA.; consulting fees from Ohtsuka Pharmaceutical Co., Takeda Pharmaceutical Co., Johnson & Johnson K.K., and Nippon Zoki Pharmaceutical Co., Ltd.; honoraria from Pfizer Japan Inc., MSD K.K., Chugai Pharmaceutical Co., Takeda Pharmaceutical Co., Janssen Pharmaceutical K.K., Boehringer Ingelheim International GmbH, Eli Lilly Japan K.K., Maruho Co., Ltd, Mitsubishi Tanabe Pharma Co., Novartis Pharma K.K., Allergan Japan K.K., Novo Nordisk Pharma Ltd, Toa Eiyo Ltd, Dentsu Co., Ono Pharmaceutical Co., Ltd, GSK, Alexion Pharmaceuticals, Inc., Canon Medical Systems Co., Kowa Company Ltd, Araya, and AbbVie Inc.; stock option from BonBon Inc.; and donation from CancerScan and YUYAMA Co., Ltd. All the other authors declare no competing interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nobukazu Agatsuma, MD, Doctor, Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. agatsuma@kuhp.kyoto-u.ac.jp
Received: December 27, 2023
Peer-review started: December 27, 2023
First decision: January 5, 2024
Revised: January 17, 2024
Accepted: February 20, 2024
Article in press: February 20, 2024
Published online: March 14, 2024
Processing time: 78 Days and 8.9 Hours
Core Tip

Core Tip: Colorectal cancer (CRC) screening reduces CRC deaths, yet several patients remain unscreened. To encourage more individuals to participate in screening, identifying subgroups at high risk is crucial. This study used cancer registries from two Japanese facilities to clarify the stage at diagnosis in three groups: cancer screening, follow-up (patients detected during follow-up for other comorbidities), and symptomatic. The proportion of early-stage diagnoses was higher in the follow-up group than in the symptomatic group and was comparable to that in the cancer screening group. Therefore, CRC screening should be recommended, particularly for patients without periodical hospital visits for comorbidities.