Report in English with a Dutch summary (KCE reports 45A)
Report in English with a Dutch summary (KCE reports 45A) Report in English with a Dutch summary (KCE reports 45A)
32 Screening for Colorectal Cancer KCE reports vol.45 100% 5y survival (%) 90% 80% 70% 60% 50% 40% 30% 20% 10% I II III IV Unknown 0% 0 12 24 36 48 60 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Months Figure 10: Invasive colorectal cancers: relative survival by stage over 5 years, 1997 2001 (source: Vlaams Agentschap Zorg en Gezondheid 39) This high impact of stage at diagnosis on survival is present in both genders as illustrated by Figure 11. The same observation applies to age groups 40 - 60 y and 60+ (not shown). CRC relative 5y survival by TNM stage and gender, Flanders, 1997-2001 Males Females M & F TNM I TNM II TNM III TNM IV Stage unknown TNM stage Figure 11: CRC relative 5-year survival by TNM stage and gender, 1997 2001 (source: Vlaams Agentschap Zorg en Gezondheid 39) For comparison, more differentiated data, based on TNM staging, 6 th edition (Figure 12) were published by the American Joint Committee on Cancer
KCE reports vol.45 Screening for Colorectal Cancer 33 (AJCC) 45: data came from a total of 119.363 patients, diagnosed with colon adenocarcinoma in the SEER (Surveillance, Epidemiology, and End Results) national cancer registry from January 1 st, 1991 through December 31 th, 2000. The SEER program is a population-based tumor registry that collects patient records from multiple sites across the United States. These data essentially show a similar importance of stage at diagnosis as observed in Flanders. Figure 12: Five-year survival by the AJCC 6th edition system stages I- IV ( source: The National Cancer Institute - USA - http://www.cancer.gov/ ) Key messages Colorectal cancer is the third most common malignant neoplasm in the world and the second cause of cancer death. Colorectal cancer incidence typically rises after the age of 40 in both genders, but more slowly in women and, at every age, women have a lower incidence of colorectal cancer than men. Accurate tumor staging (TNM staging) is very important as stage is a strong predictor of survival, independent from age and gender. In Flanders (2000 - 2001) crude 5-year survival was 46% in men and 47% in women. Colorectal cancer relative 5-year survival was 57% in males and females.
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32 Screen<strong>in</strong>g for Colorectal Cancer <strong>KCE</strong> <strong>reports</strong> vol.45<br />
100%<br />
5y survival (%)<br />
90%<br />
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70%<br />
60%<br />
50%<br />
40%<br />
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I II III IV Unknown<br />
0%<br />
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100%<br />
90%<br />
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60%<br />
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Figure 10: Invasive colorectal cancers: relative survival by stage over<br />
5 years, 1997 2001 (source: Vlaams Agentschap Zorg en<br />
Gezondheid 39)<br />
This high impact of stage at diagnosis on survival is present <strong>in</strong> both genders as<br />
illustrated by Figure 11. The same observation applies to age groups 40 - 60 y<br />
and 60+ (not shown).<br />
CRC relative 5y survival by TNM stage and gender, Flanders, 1997-2001<br />
Males Females M & F<br />
TNM I TNM II TNM III TNM IV Stage unknown<br />
TNM stage<br />
Figure 11: CRC relative 5-year survival by TNM stage and gender,<br />
1997 2001 (source: Vlaams Agentschap Zorg en Gezondheid 39)<br />
For comparison, more differentiated data, based on TNM stag<strong>in</strong>g, 6 th edition<br />
(Figure 12) were published by the American Jo<strong>in</strong>t Committee on Cancer