Abstract
BackgroundLittle is known about colorectal cancer or colon and rectal cancer. Are they the same disease or different diseases?ObjectivesThe aim of this epidemiology study was to compare the features of colon and rectal cancer by using recent national cancer surveillance data.Design and settingData included colorectal cancer (1995–2008) from the Surveillance, Epidemiology, and End Results Program (SEER) database. Only adenocarcinoma was included for analysis.PatientsA total of 372,130 patients with a median follow-up of 32 months were analyzed.Main outcome measuresMean survival of patients with the same stage of colon and rectal cancer was evaluated.ResultsAround 35% of patients had stage information. Among them, colon cancer patients had better survival than those with rectal cancer, by a margin of 4 months in stage IIB. In stage IIIC and stage IV, rectal cancer patients had better survival than colon cancer patients, by about 3 months. Stage IIB colorectal cancer patients had a poorer prognosis than those with stage IIIA and IIIB colorectal cancer. After adjustment of age, sex and race, colon cancer patients had better survival than rectal cancer of stage IIB, but in stage IIIC and IV, rectal cancer patients had better survival than colon cancer.LimitationsThe study is limited by its retrospective nature.ConclusionThis was a population-based study. The prognosis of rectal cancer was not worse than that of colon cancer. Local advanced colorectal cancer had a poorer prognosis than local regional lymph node metastasis. Stage IIB might require more aggressive chemotherapy, and no less than that for stage III.
Highlights
Colorectal cancer is the third most common cancer among both men and women in the United States [1]
Among deceased persons listed in the SEER Registry, death may have occurred from colorectal cancer or any other cause of death
The colon cancer incidence was twice greater than the rectal cancer incidence in the current cohort (Table 1)
Summary
Colorectal cancer is the third most common cancer among both men and women in the United States [1]. Rectal cancer makes up approximately 25% of large bowel cancers in the Western world. Colon and rectal cancer share many similar clinical features and are often referred to as colorectal cancer. Despite the existence of two entities, 5FU-based chemotherapy regimens are given for both, except radiation therapy is often needed for rectal cancer. If there is really a difference between colon and rectal cancer, we should consider them separately and treat them respectively. Little is known about colorectal cancer or colon and rectal cancer. Are they the same disease or different diseases?
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