Cancer of the Colon and Rectum
           St. Anthony’s 1987 – 2001

Colorectal cancer is the fourth most common cancer in the US accounting for 11% of all cancers. At St. Anthony’s Hospital (SAH) this cancer is the third most common cancer and accounts for 14% of all cases in the Tumor Registry. We reviewed all  analytic cases in the registry from 1987 through 2001 were reviewed and the data compared to the National Cancer Data Base (NCDB) and the NCI SEER data base. For the purposes  of this study rectosigmoid was included with rectum to be comparable to the NCDB database. Patients with multiple primaries were excluded from the study.

There were 1,579 cases, and the numbers have been stable over the last 15 years as noted in figure 1. The distribution between colon and rectum are as noted below:

SAH

Ratio

NCDB

Colon

484/640

43:57

49:51

Rectum

217/228

49:51

57:43

Age: The patients at SAH were somewhat older than average with a median age of  76y (national 72y, see figure2).

Stage: Stage distribution using the AJCC system as noted below and in figures 3 colon and 4 rectum

Stage

SAH

%

NCDB

0

78

7%

7%

I

252

23%

24%

II

361

32%

28%

III

223

19%

23%

IV

160

14%

18%

Stage

SAH

%

NCDB

0

39

9%

9%

I

144

32%

29%

II

100

22%

24%

III

77

17%

27%

IV

53

12%

11%

Survival:    According to the NCI the 5 year relative survival for colorectal cancer was 62% 1992-1998. The 5-year relative survival from SAH compares favorably (64%) and 5 year observed survival was 44%.  Survival comparisons by stage are noted below and in figures 5 colon and 6 rectum;  and SEER data by stage figure 7 and survival figure 8.   (The NCDB is now reporting observed survival rather than relative survival on their web site, so we have looked at both sets of data. Since observed survival does not adjust for age, an older population will have a downward skewed outcome with this type of analysis.) The overall stage distribution and survival comparisons are quite favorable for the patients treated at St. Anthony's Hospital.

Stage

SAH Colon

NCDB Colon

SAH Rectum

NCDB Rectum

I

86%

70%

93%

72%

II

80%

60%

73%

52%

III

56%

44%

52%

37%

IV

7%

7%

3%

4%