Population‐based study of the treatment and prognosis of carcinoma of the rectum

Goudet, P.; Roy, Prodyot Kumar; Arveux, I.; Cougard, P; Faivre, Jean

doi:10.1111/j.1365-2168.1997.02844.x

Cited by 14 publications

(3 citation statements)

References 11 publications

(8 reference statements)

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“…[2][3][4][5][6][7][8][9][10][11] Previous studies have shown great variability in the care and outcome of patients with colorectal cancer. 12,13 Age-adjusted colon cancer mortality rates are significantly higher for Black patients than for White patients. [14][15][16] Colorectal cancer mortality rates are falling among White patients but rising among Black patients.…”

mentioning

confidence: 99%

Effects of health insurance and race on colorectal cancer treatments and outcomes

Roetzheim

Pal²,

Gonzalez³

et al. 2000

Am J Public Health

214

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OBJECTIVES: We hypothesized that health insurance payer and race might influence the care and outcomes of patients with colorectal cancer. METHODS: We examined treatments received for all incident cases of colorectal cancer occurring in Florida in 1994 (n = 9551), using state tumor registry data. We also estimated the adjusted risk of death (through 1997), using proportional hazards regression analysis controlling for other predictors of mortality. RESULTS: Treatments received by patients varied considerably according to their insurance payer. Among non-Medicare patients, those in the following groups had higher adjusted risks of death relative to commercial fee-for-service insurance: commercial HMO (risk ratio [RR] = 1.40; 95% confidence interval [CI] = 1.18, 1.67; P = .0001), Medicaid (RR = 1.44; 95% CI = 1.06, 1.97; P = .02), and uninsured (RR = 1.41; 95% CI = 1.12, 1.77; P = .003). Non-Hispanic African Americans had higher mortality rates (RR = 1.18; 95% CI = 1.01, 1.37; P = .04) than non-Hispanic Whites. CONCLUSIONS: Patients with colorectal cancer who were uninsured or insured by Medicaid or commercial HMOs had higher mortality rates than patients with commercial fee-for-service insurance. Mortality was also higher among non-Hispanic African American patients.

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confidence: 99%

Effects of health insurance and race on colorectal cancer treatments and outcomes

Roetzheim

Pal²,

Gonzalez³

et al. 2000

Am J Public Health

214

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“…36 Recruitment of eligible rectal cancer patients was 100% as indicated by a calculated incidence rate of 22.7/100 000/year and characteristics corresponding to data from the German Cancer Register and population-based studies. [44][45][46] From the methodological point of view, our results indicate that the unobserved data were not missing at random. The risk factors for non-compliance resemble those noted in work from other countries and in patients with different cancers.…”

Section: Discussionmentioning

confidence: 78%

Relation between Severe Illness and Non-Completion of Quality-of-Life Questionnaires by Patients with Rectal Cancer

et al. 2003

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Quality of life (QoL) is an important outcome measure in clinical studies, but interpretation is hindered by incompleteness of data. We addressed this issue in a population-based cohort study of 146 patients with newly diagnosed rectal cancer. QoL was assessed by means of European Organization for the Research and Treatment of Cancer questionnaires at discharge from hospital after primary treatment and then every 3 months for 2 years. In parallel, objective clinical data were documented. Analyses were conducted in three steps: participants versus non-participants with QoL-assessment; poor compliers who filled in only one or two questionnaires (n=20) versus good compliers who filled in all or nearly all questionnaires (n=18); and the proportion of missing forms and critical (very poor) QoL scores in risk patients versus non-risk patients over the course of 2 years. Non-participants and poor compliers were older, were more likely to receive palliative (rather than curative) treatment, and had worse scores for physical status. Tumour progression and therapeutic interventions were more frequent in poor compliers than in good-compliers. Patients with risk factors (age 475 years, poor physical status, palliative treatment) were more likely to have missing questionnaires and critical QoL scores in respect of physical functioning and global quality of life over the course of 2 years. Missing values for QoL have clinical as well as methodological implications, because QoL scores can enhance a clinician's insight. Unwillingness to fill in a questionnaire is an indicator of serious illness. Studies that report sample statistics without specifying compliance rates and the characteristics of non-compliers will give a misleadingly positive picture.

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“…As diagnostic assessment is performed more and more precisely and surgical techniques have been clearly improved within the last decade, the rate of curative resections and sphincter-saving procedures for rectal cancer has been significantly increased and mortality rate decreased [9]. Therefore, the accepted policy for surgical treatment of rectal cancer is to perform TME as part of either anterior resection or abdominoperineal excision [10].…”

Section: Disscussionmentioning

confidence: 99%

Mesorectal spread and micrometastasis of rectal cancer studied with large slice technique and tissue microarray

et al. 2005

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Combination of large slice and tissue microarray provided a more detailed method in studying the spread of rectal cancer. Complete excision of the mesorectum with fascia propria circumferentially intact is essential since there is an outer scattering and lateral discrepancy for neoplastic foci distribution. Circumferential margin involvement and micrometastasis observed suggested adoption of preoperative and/or postoperative radiochemotherapy.

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Population‐based study of the treatment and prognosis of carcinoma of the rectum

Abstract: This study indicates that significant advances have been achieved at a population level in the treatment of rectal cancer in terms of diagnosis, continence-preserving procedures and survival.

Cited by 14 publications

References 11 publications

Effects of health insurance and race on colorectal cancer treatments and outcomes

Effects of health insurance and race on colorectal cancer treatments and outcomes

Relation between Severe Illness and Non-Completion of Quality-of-Life Questionnaires by Patients with Rectal Cancer

Mesorectal spread and micrometastasis of rectal cancer studied with large slice technique and tissue microarray

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