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. 2026 Feb 22.
doi: 10.1002/jso.70206. Online ahead of print.

Association Between Colorectal Cancer Screening and Survival in Patients Older Than 70 Years: Results of A National Multicenter Retrospective Study

Matteo Rottoli  1   2 , Giacomo Calini  1   2 , Giovanni Castagna  1   2 , Alice Gori  1   2 , Stefano Cardelli  1   2 , Antonino Spinelli  3   4 , Gianluca Pellino  5   6 , Alessandro Bianconi  2 , Matteo Fiore  2 , Riccardo Rosati  7 , Mario Morino  8 , Nicolò de Manzini  9 , Andrea Pietrabissa  10 , Luigi Boni  11 , Gilberto Poggioli  1   2 ; COVID‐CRC Study Group
Collaborators, Affiliations

Association Between Colorectal Cancer Screening and Survival in Patients Older Than 70 Years: Results of A National Multicenter Retrospective Study

Matteo Rottoli et al. J Surg Oncol. .

Abstract

Background: Colorectal cancer screening mainly targets a population between 50 and 70 years of age; however, it is inconsistently implemented in people over 70. The aim of this study was to analyze the association between colorectal cancer (CRC) screening, postoperative mortality, and perioperative and oncologic outcomes in a large population of patients over 70 years of age who underwent surgery for CRC.

Methods: Data regarding people over 70 who underwent CRC surgery were retrieved from a nationally validated retrospective database, including four consecutive years (2018-2021) and 81 centers. The patients were divided into two groups according to their participation in the CRC screening program: Screening versus No Screening. The outcomes of the study were 30-day mortality; urgent, palliative and minimally invasive surgery rates; Clavien-Dindo ≥ III; advanced oncologic stage; R0 resection and length of hospital stay (LOS). Logistic regression analysis was carried out and adjusted for multiple confounders.

Results: Of the 10,346 patients over 70,676 were in the screening group, and 9670 were in the no screening group. At logistic regression, CRC screening was significantly associated with a reduction in 30-day mortality (OR 0.41, 95% CI 0.18-0.92, p = 0.032), urgent surgery (OR 0.06, 95% CI 0.02-0.14, p < 0.001), palliative surgery (OR 0.32, 95% CI 0.19-0.54, p < 0.001), Clavien-Dindo ≥ III complications (OR 0.69, 95% CI 0.51-0.93, p = 0.016) and advanced oncologic stage (OR 0.53, 95% CI 0.45-0.62, p < 0.001), and a significant increase in R0 resections (OR 3.15, 95% CI 1.67-5.94, p < 0.001) and laparoscopic surgery (OR 1.93, 95% CI 1.57-2.38, p < 0.001). The crude and adjusted Odds Ratio similarity confirmed this correlation, regardless of the comorbidities and confounders.

Conclusions: Adherence to CRC screening should be further encouraged and standardized for people over 70.

Keywords: colorectal cancer; over 70 years old; screening; survival.

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