Trends in colorectal cancer surgical resection rates during the screening era: a retrospective study in Italy

Sep 21, 2026

Uploaded by Oliver

Background, objectives, and design focus on how FIT-based colorectal cancer screening affects surgical resection patterns across anatomic sites. Age-adjusted surgical resection rates were compared by proximal colon, distal colon, and rectum, and by age group and sex over 20 years in a large Italian population. Data from the Veneto Region administrative Hospital Discharge Dataset included over 54,000 patients (40–89) undergoing CRC surgery between 2002 and 2021, showing increases until 2007, followed by site-specific declines after screening.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

What is already known on this topic

What this study adds

How this study might affect research, practice or policy

Introduction

Colorectal cancer To cite: Zorzi M, Calciano L, Gennaro N, et al. Trends in colorectal cancer surgical resection rates during the screening era: a retrospective study in Italy. BMJ Open Gastroenterol 2024;11:e001434 . doi:10 . 1136/ bmjgast-2024-001434 ► Additional supplemental material is published online only. To view, please visit the journal online ([https://doi](https://doi). org/10.1136/bmjgast-2024- 001434) . Received 10 April 2024 Accepted 19 July 2024 © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 1Epidemiological Department, Azienda Zero, Padova, Italy 2Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padova, Italy 3Department of Medicine (DIMED), Pathology and Cytopathology Unit, University of Padua, Padova, Italy Correspondence to Dr Lucia Calciano; [lucia.calciano@azero.veneto.it](lucia.calciano@azero.veneto.it) Trends in colorectal cancer surgical resection rates during the screening era: a retrospective study in Italy Manuel Zorzi,1 Lucia Calciano ,1 Nicola Gennaro,1 Laura Memo,1 Silvia Rizzato,1 Carmen Stocco,1 Emanuele D L Urso,2 Silvia Negro,2 Gaya Spolverato,2 Salvatore Pucciarelli ,2 Marta Sbaraglia,3 Stefano Guzzinati1 ABSTRACT Background Faecal immunochemical test (FIT)-based screening is effective in reducing colorectal cancer (CRC) incidence, but its sensitivity for proximal lesions remains low. Objectives We compared age-adjusted CRC surgical resection rates across anatomic sites (proximal colon, distal colon, rectum), age groups and sex over 20 years in a large Italian population. We particularly focused on changes in trends following FIT-screening implementation in the target population (50–69 years) . Design This retrospective study analysed data from the Veneto Region’s administrative Hospital Discharge Dataset, involving over 54 000 patients aged 40–89 (43.4% female) who underwent CRC surgery between 2002 and 2021. Results Overall, surgery rates increased until 2007 (annual percentage changes: 2.5% in males, 2.9% in females) and then declined (−4 .2% in males, −3 .4% in females) . This decline was steeper for distal and rectal cancers compared with proximal cancer, suggesting a shift towards more right-sided CRC surgery. In males, the prescreening increase in proximal surgery was reversed after screening implementation (slope change: −6%) while the prescreening decline accelerated for distal (−4%) and rectal (−3%) surgeries. In females, stable prescreening trends shifted downward for all sites (−5% for proximal, −8% for distal and −7% for rectal surgery) . However, the change in trends between prescreening and postscreening periods was not different across anatomic sites for either sex (all slope change differences in pairwise comparisons were not statistically significant) . Conclusion The shift towards proximal surgery may not be entirely due to the FIT’s low sensitivity but may reflect an underlying upward trend in proximal cancers independent of screening. INTRODUCTION Colorectal cancer (CRC) stands as one of the most prevalent global cancers, ranking third in terms of incidence (with 1.9 million new cases, excluding anal cancer) and second in terms of mortality (with 0.9 million deaths) in 2020.1 Within the European Union (EU), CRC poses a substantial burden, as evidenced by age-standardised incidence and mortality WHAT IS ALREADY KNOWN ON THIS TOPIC | ⇒ Previous research suggests a higher faecal immunochemical test (FIT) sensitivity for distal colorectal lesions compared to proximal ones.
WHAT THIS STUDY ADDS | | --- | | ⇒ We observed a shift towards proximal colon surgeries during the 20-year study period. However, similar reductions in surgery resection rates across all anatomic sites (distal, proximal and rectum) took place following FIT programme implementation.
HOW THIS STUDY MIGHT AFFECT

FAQs

What is the main focus of this retrospective study?

The study compares age-adjusted surgical resection rates for colorectal cancer across anatomic sites and demographic groups over 20 years, with attention to changes after FIT screening implementation.

Which dataset and patient population were analyzed?

The analysis used the Veneto Region administrative Hospital Discharge Dataset, including over 54,000 patients aged 40–89 who underwent CRC surgery between 2002 and 2021.

What trend changes were observed after FIT screening implementation?

Surgery rates increased until 2007 and then declined overall. The decline was steeper for distal and rectal cancers than for proximal cancer, indicating a shift toward more right-sided/proximal CRC surgery.

Sep 21, 2026

Uploaded by Oliver