Survival Rates and Associated Factors of Colorectal Cancer Patients in Brunei Darussalam

Abstract

Background: Colorectal cancer (CRC) is the third most common cancer in both men and women. In most Asian countries, both the incidence and mortality rates of CRC are gradually increasing. In Brunei Darussalam, CRC ranks first and second in lifetime risk among men and women respectively. This study aims to report the overall survival rates and associated factors of CRC in Brunei Darussalam. Methods: This is a retrospective study examining CRC data for the period 2007 to 2017 retrieved from a population based cancer registry in Brunei Darussalam. A total of 728 patients were included in the analysis. Kaplan Meier method was used to estimate survival rates. Univariate analysis using log-rank test was used to examine the differences in survival between groups. Multivariate analysis using Cox PH regression was used to estimate hazard of death and obtain significant predictors that influence CRC patients' survival. Results: The median survival time for colorectal, colon and rectal cancer patients were 57.0, 85.8 and 40.0 months respectively. The overall 1-, 3-and 5-year survival rates for CRC patients were 78.0%, 57.7% and 49.6% respectively. In univariate analysis, age at diagnosis, ethnicity, cancer stage, tumour location and histology were found to have significant difference in CRC patients' survival. In the Cox PH analysis, older age (≥70 years), cancer stage, ethnicity and other histological type were determined as associated factors of CRC patients' survival. Conclusion: This study found the overall 5-year survival rate of CRC in Brunei Darussalam is similar to that in some Asian countries such as Singapore and Malaysia. However, more efforts need to be carried out in order to raise awareness of CRC and improve the survival of CRC patients.

Survival Outcomes of Metastatic Colorectal Cancer Patients in Brunei Darussalam and the Impact of <em>KRAS</em> Mutations

“…Within Asia, India was found to have the lowest survival rate of 31.2% for CRC patients while China has the highest with survival rate of 77% [27,28]. The survival rate of mCRC patients found within this study was 44.7% while the reported five year survival rate for CRC reported by Leong et al was 49.6% [5].There are more cases of male mCRC patients than female mCRC patients and a slightly shorter survival period of the male mCRC patients in our study ( Table 1). Prior research has indicated that gender contributes to survival outcomes and females were deemed to have better OS [29], possibly due to the protective effects of female sex hormones against CRC [30,31].…”

“…To our knowledge, this is the first study in Brunei Darussalam to analyse both the survival outcomes of metastatic CRC patients and those of mutant KRAS mCRC patients. Although a recent paper published on the survival rates and associated factors of CRC patients in Brunei Darussalam [5], investigation on survival outcomes of mutant KRAS mCRC patients and exploration on the various KRAS mutations in these patients are still in its infancy in this country. The reported median survival period was 57.0 months for CRC [5], while for mCRC patients, we estimated that the median survival period was 29.0 months.…”

“…Although a recent paper published on the survival rates and associated factors of CRC patients in Brunei Darussalam [5], investigation on survival outcomes of mutant KRAS mCRC patients and exploration on the various KRAS mutations in these patients are still in its infancy in this country. The reported median survival period was 57.0 months for CRC [5], while for mCRC patients, we estimated that the median survival period was 29.0 months. Within Asia, India was found to have the lowest survival rate of 31.2% for CRC patients while China has the highest with survival rate of 77% [27,28].…”

“…With the increased incidence of CRC, national colorectal cancer screening programmes were encouraged and initiated in a number of Asian countries to ensure early detection and treatment of CRC, with a view to lower the CRC mortality rates [3,4]. According to a retrospective study spanning from 2007 to 2017, the median survival period for colorectal cancer patients in Brunei Darussalam was 57.0 years [5].…”

Self- Reported Personal and Family History of Cancers in Brunei Darussalam: Result of an Integrated Health Survey

“…This finding can be explained by the fact that our study population were young and cancers affecting females are commonly diagnosed younger than other cancers; breast (majority in the fourth and fifth decades) and gynecological cancer (i.e. cervical cancers between third and fifth decades) (Leong et al, 2019;Ong et al, 2018). Self-reported history of cancers in offspring or children having cancers only accounted for a small proportion of 0.1%, and this is not unexpected given the age demographic of our participants.…”