Colorectal cancer mortality after spinal cord injury

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2020.1808294 · Published: May 1, 2022

Spinal Cord Injury Oncology Public Health

Simple Explanation

This study aimed to compare colorectal cancer (CRC) mortality in individuals with spinal cord injury (SCI) to that of the general population in the United States. The study found that overall, persons with SCI are not at an increased risk of CRC mortality compared to the general population. However, a statistically significant subgroup was identified: patients with injury level C1-4 with an American Spinal Injury Association Impairment Scale Grade of A, B or C showed a higher CRC mortality rate.

Study Duration

Not specified

Participants

54,965 persons with SCI

Evidence Level

Prospective follow-up study

Key Findings

1
The overall standardized mortality ratio (SMR) for CRC mortality in the SCI population was 1.11 (95% CI [0.94, 1.31]), indicating no statistically significant increase compared to the general population.
2
A statistically significant subgroup was found: patients with injury level C1-4 and an American Spinal Injury Association Impairment Scale Grade of A, B, or C had an SMR of 1.68 (95% CI [1.03–2.61]).
3
The CRC mortality was 146 persons out of 54,965 persons with SCI.

Research Summary

This study compared CRC mortality in SCI patients to CRC mortality in the general population to determine if any disparities exist. The study found no significant difference in overall CRC mortality between the general population and the SCI population. A statistically significant subgroup was identified: patients with injury level C1-4 with an American Spinal Injury Association Impairment Scale Grade of A, B or C had an increased mortality rate.

Practical Implications

CRC Screening Recommendations

The current recommendations for CRC screening should be continued for individuals with SCI.

Reducing Barriers to Care

Efforts should be made to reduce barriers to care for individuals with SCI, especially those with high-level injuries.

Further Research

Future research should focus on evaluating CRC incidence, screening rates, and risk factors in persons with SCI and varying neurological groups.

Study Limitations

1
Cancer incidence, timing of diagnosis, response to treatment and cancer pathologies were variables that were not available in the database for further assessment.
2
The NSCID is not representative of all SCI in the United States.
3
Cause of death is not always accurately reflected on death certificates.

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