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Cancer Trends Progress Report – 2009/2010 Update

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In the Report
Introduction
Trends-at-a-Glance
Summary Tables
Prevention
Early Detection
Diagnosis
Treatment
Bladder Cancer Treatment
Breast Cancer Treatment
> Colorectal Cancer Treatment
Kidney Cancer Treatment
Lung Cancer Treatment
Ovarian Cancer Treatment
Prostate Cancer Treatment
Life After Cancer
End of Life



Colorectal Cancer Treatment
Treatment

The proportion of patients receiving appropriate adjuvant therapy has increased steadily since 1987. Potential disparities remain for some groups of patients.

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Benefits of Treatment

On the basis of accumulated evidence from clinical trials, a 1990 NIH Consensus Development Conference recommended that patients with stage III colon cancer be given adjuvant chemotherapy. The 1990 NIH Consensus Conference also recommended combined adjuvant chemotherapy and high-dose external-beam radiotherapy for stage II and III rectal cancer. Radiation does not appear to affect disease-specific or overall survival for rectal cancer, although it does decrease local recurrence.

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Measure

Percent of individuals, aged 20 years and older, diagnosed with stage III colon cancer who received chemotherapy or diagnosed with stage II or stage III rectal cancer who received chemotherapy with or without radiotherapy.

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Period – 1987–2005

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Trends – Rising rapidly from 1987 to 1990, rising moderately from 1990 to 2005.

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Most Recent Estimates

In 2005, 60 percent of stage III colon and stage II and III rectal patients aged 65 years and older received adjuvant chemotherapy, while more than 85 percent of patients aged 20 to 64 received chemotherapy.

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Healthy People 2010 Targets

There are no Healthy People 2010 targets for cancer treatment, including colorectal cancer treatment.

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Groups at High Risk for Not Receiving Appropriate Treatment

Studies have found that older colorectal patients are less likely to receive adjuvant chemotherapy treatment, even after adjustment for the higher rate of pre-existing co-morbid conditions among older patients. Even elderly patients with no or very few co-morbid conditions, such as diabetes, kidney disease, or heart disease, were less likely to receive treatment. Earlier studies indicated that Black patients were less likely to receive treatment than White patients; however, this disparity was not found in the 2000 NCI Patterns of Care/Quality of Care study. However, older patients continue to receive adjuvant chemotherapy less often than younger patients.

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Key Issues

Chemotherapy for colorectal cancer is a rapidly evolving field. Emerging treatments include chemotherapy regimens that incorporate irinotecan and/or oxaliplatin agents that interfere with DNA synthesis during cancer cell division and, more recently, anti-angiogenesis agents. These newer drugs result in better outcomes for many colorectal cancer patients, but they also are much more expensive than earlier treatments.

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Additional Information on Colorectal Cancer Treatment

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Back: Breast Cancer Treatment

National Cancer InstituteDepartment of Health and Human ServicesNational Institutes of HealthUSA.gov