Estimating population-based recurrence rates of colorectal cancer over time in the United States
Menée à partir des données des registres américains des cancers, cette étude présente une estimation du taux de récidive de la maladie chez des patients atteints d'un cancer colorectal diagnostiqué sur la période 1975-1984 et diagnostiqué sur la période 1994-2003
Background: Population-based metastatic recurrence rates for patients diagnosed with non-metastatic colorectal cancer (CRC) cannot be estimated directly from population-based cancer registries because recurrence information is not reported. We derived population-based CRC recurrence rates using disease-specific survival data based on our understanding of the CRC recurrence-death process.
Methods: We used a statistical continuous-time multistate survival model to derive population-based annual CRC recurrence rates from 6 months to 10 years after CRC diagnosis using relative survival data from the Surveillance, Epidemiology, and End Results Program. The model was based on the assumption that, after 6 months of diagnosis, all CRC-related deaths occur only in patients who experience a metastatic recurrence first, and that the annual CRC-specific death rate among patients with recurrence was the same as in those diagnosed with de novo metastatic disease. We allowed recurrence rates to vary by post-diagnosis time, age, stage, and location for two diagnostic time periods.
Results: In patients diagnosed in 1975-1984, annual recurrence rates 6 months-5 years post-diagnosis ranged from 0.054-0.060 in stage II colon cancer, 0.094-0.105 in stage II rectal cancer, and 0.146-0.177 in stage III CRC, depending on age. We found a statistically significant decrease in CRC recurrence among patients diagnosed in 1994-2003 compared with those diagnosed in1975-1984 for 6 months-5 years post-diagnosis (hazard ratios between 0.43-0.70).
Conclusions: We derived population-based annual recurrence rates of CRC in the US for up to 10 years post-diagnosis using relative survival data.
Impact:Our estimates can be used in decision-analytic models to facilitate analyses of CRC interventions that are more generalizable.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2019