Microsatellite Instability in Interval Colon Cancers

Mandeep S. Sawhney, William D. Farrar, Srivani Gudiseva, Douglas B. Nelson, Frank A Lederle, Thomas S. Rector, John H. Bond

Research output: Contribution to journalArticlepeer-review

234 Scopus citations


Background & Aims: Colon cancers that develop after a complete colonoscopy may be the result of "failure of colonoscopy" or rapid tumor growth. Tumors that develop via the mismatch repair gene pathway demonstrate rapid tumor growth. The aim of this study was to determine if interval colon cancers were more likely than noninterval cancers to result from the loss of function of mismatch repair genes and hence demonstrate microsatellite instability (MSI). Methods: We searched our institution's cancer registry for interval cancers, defined as colon cancers that developed within 5 years of a complete colonoscopy. These were frequency matched in a 1:2 ratio by age and sex to patients with noninterval cancers (defined as colon cancers diagnosed on a patient's first recorded colonoscopy). Archived cancer specimens for all subjects were retrieved and tested for MSI. Results: Of the 993 colon cancers diagnosed during the study period, 51 (5.1%) were identified as an interval cancer, and 112 subjects with noninterval cancer served as a comparison group. Study subjects were almost all men. MSI was found in 30.4% of interval cancers compared with 10.3% of noninterval cancers (P = .003). After adjusting for age, interval cancers were 3.7 times more likely to show MSI than noninterval cancers (95% confidence interval, 1.5-9.1). This association was strongest for tumors located in the distal colon (odds ratio, 17.5; P = .008). No difference in TNM stage at diagnosis, histologic type or grade, or 5-year survival was found between groups. Conclusions: Interval colon cancers were almost 4 times as likely as noninterval colon cancers to be associated with mismatch repair gene dysfunction.

Original languageEnglish (US)
Pages (from-to)1700-1705
Number of pages6
Issue number6
StatePublished - Dec 2006

Bibliographical note

Funding Information:
Supported in part by the VA Clinical Science R&D Service (grant 04S-CRCOE-001 to M.S.S. and T.S.R.) and a grant from the Minnesota Medical Foundation (Minneapolis, MN).

Copyright 2018 Elsevier B.V., All rights reserved.


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