Context: Colorectal cancer (CRC) is the second leading cause of cancer related deaths in the US. There is paucity of data regarding CRC and the spinal cord injury (SCI) community. Persons with SCI have suboptimal rates of colonoscopies and face extensive barriers to care. The aim of our study was to compare CRC mortality in persons with SCI to CRC mortality in the general population.

Design: A prospective follow-up study.

Setting: Analysis of the National SCI database.

Participants: 54,965 persons with SCI.

Interventions: Not applicable.

Outcome Measures: Current survival status and causes of death were determined. The expected number of CRC deaths was calculated for the general US population, using ICD-10 codes. Standardized mortality ratios (SMR) were calculated as the ratio of observed to expected CRC deaths stratified by current age, sex, race, time post-injury and neurologic group.

Results: The CRC mortality was 146 persons out of 54,965 persons with SCI. The overall SMR was determined to be 1.11 (95% CI [0.94, 1.31]). Among subgroups, one finding was significant and this was for patients with injury level C1-4 with an American Spinal Injury Association Impairment Scale Grade of A, B or C with an SMR of 1.68 ([95% CI [1.03–2.61]).

Conclusion: Although persons with SCI receive suboptimal rates of preventative care screenings and report extensive barriers to care, overall, they are not at an increased risk of CRC mortality. The current recommendations for CRC screening should be continued for these individuals while reducing barriers to care.

背景：结直肠癌（CRC）是美国癌症相关死亡的第二大原因。缺乏关于 CRC 和脊髓损伤 (SCI) 社区的数据。SCI 患者的结肠镜检查率不理想，并且面临广泛的护理障碍。我们研究的目的是比较 SCI 患者的 CRC 死亡率与普通人群的 CRC 死亡率。

设计：一项前瞻性随访研究。

设置：国家 SCI 数据库的分析。

参与者： 54,965 名 SCI 患者。

干预：不适用。

结果测量：确定了当前的生存状态和死亡原因。使用 ICD-10 代码计算了美国普通人群的预期 CRC 死亡人数。标准化死亡率 (SMR) 计算为按当前年龄、性别、种族、受伤后时间和神经系统组分层的观察到的与预期的 CRC 死亡之比。

结果：在 54,965 名 SCI 患者中，CRC 死亡率为 146 人。总 SMR 确定为 1.11 (95% CI [0.94, 1.31])。在亚组中，一项发现具有显着意义，这是针对损伤等级为 C1-4 且美国脊髓损伤协会损伤量表等级为 A、B 或 C 级且 SMR 为 1.68 的患者（[95% CI [1.03–2.61]）。

结论：尽管 SCI 患者的预防性护理筛查率不理想，并且报告存在广泛的护理障碍，但总体而言，他们的 CRC 死亡率风险并未增加。应继续为这些人提供当前的 CRC 筛查建议，同时减少护理障碍。