An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients

Abstract

Regarding the continuous changes in the diagnostic process and treatment of colorectal cancer (CRC), it is important to evaluate long‐term trends which are relevant in giving direction for further research and innovations in cancer patient care. The aim of this study was to analyze developments in incidence, treatment and survival for patients diagnosed with CRC in the Netherlands. For this population‐based retrospective cohort study, all patients diagnosed with CRC between 1989 and 2014 in the Netherlands were identified using data of the nationwide population‐based Netherlands Cancer Registry (n = 267,765), with follow‐up until January 1, 2016. Analyses were performed for trends in incidence, mortality, stage distribution, treatment and relative survival measured from the time of diagnosis. The incidence of both colon and rectal cancer has risen. The use of postoperative chemotherapy for Stage III colon cancer increased (14–60%), as well as the use of preoperative (chemo)radiotherapy for rectal cancer (2–66%). The administration of systemic therapy and metastasectomy increased for Stage IV disease patients. The 5‐year relative survival increased significantly from 53 to 62% for colon cancer and from 51 to 65% for rectal cancer. Ongoing advancements in treatment, and also improvement in other factors in the care of CRC patients—such as diagnostics, dedicated surgery and pre‐ and postoperative care—lead to a continuous improvement in the relative survival of CRC patients. The increasing incidence of CRC favors the implementation of the screening program, of which the effects should be monitored closely.

Nationwide trends in incidence, treatment and survival of pancreatic ductal adenocarcinoma

“…It appears that improvements in oncological treatments of any kind are the most likely explanations for the increased overall survival. However, the overall survival advantage for all patients is disappointing compared with for example colorectal cancer [23]. It is clear that improvements are needed, for instance through early detection of PDAC and better or individualised treatments [24].…”

The Impact of Primary Tumor Location in Synchronous Metastatic Colorectal Cancer: Differences in Metastatic Sites and Survival

“…The 5-year relative survival of mCRC increased from 4 to 12%, mainly due to intensified and more effective treatment. 3 Primary tumor location in CRC has prognostic value, suggesting that right-sided colon (RCC), left-sided colon (LCC), and rectal cancer can be regarded as different entities. Population-based studies found that patients with metastasized LCC had better survival compared with patients with metastasized RCC and demonstrated that in recent years patients with metastasized rectal cancer had a better survival than patients with metastasized colon cancer.…”

ASPP1 deficiency promotes epithelial-mesenchymal transition, invasion and metastasis in colorectal cancer

“…Lifestyle factors, including smoking, diet, lack of exercise, combined with an aging population all contribute to an increased risk of CRC 39 . A number of advances have been made in recent years to both treatment and diagnosis; however, despite new treatments doubling survival for advanced disease 39 , prognosis for metastatic disease is still poor 40 . CRC frequently metastasizes to both the lungs and the liver, and this is a leading cause of treatment failure with up to 50% of CRC patients developing metastatic liver disease after resection of the primary tumour 41 .…”