Abstract
Evidence is limited regarding the effect of diagnosis-to-treatment interval (DTI) on the survival of colorectal cancer (CRC) patients. In addition, previous studies on treatment delay and CRC survival have largely grouped patients from all stages (I-IV) into one cohort. Our study provides analysis on each stage individually. We conducted a retrospective cohort study with 39,000 newly diagnosed CRC patients obtained from the Taiwan Cancer Registry Database from 2004–2010 to examine the effect of DTIs on overall survival. DTIs were divided into 3 groups: ≤ 30 days (36,115 patients, 90.5% of study patients), 31–150 days (2,533, 6.4%), and ≥ 151 days (1,252, 3.15%). Risk of death was increased for DTI 31–150 days (hazard ratio 1.51; 95% confidence interval 1.43–1.59) and DTI ≥ 151 days (1.64; 1.54–1.76) compared to DTI ≤ 30. This risk was consistent across all cancer stages. Additional factors that increased risk of death include male gender, age >75, Charlson Comorbidity Index ≥7, other catastrophic illnesses, lack of multidisciplinary team involvement, and treatment in a low volume center. From these results, we advise that the DTI for all CRC patients, regardless of cancer staging, should be 30 days or less.
Highlights
There is an estimated 50,630 deaths from colorectal cancer (CRC) in 2018 in the United States, second only to lung cancer [1]
The diagnosis-to-treatment interval (DTI) for CRC in this study were divided into three groups: 30 days, 31–150 days, and 151 days. 36,115 study subjects (90.5%) received treatment within 30 days of a confirmed diagnosis; 2533 (6.4%) did so between 31–150 days; and 1,252 (3.1%) did not receive treatment until more than 151 days after diagnosis
Factors associated with overall survival in colorectal cancer patients
Summary
There is an estimated 50,630 deaths from colorectal cancer (CRC) in 2018 in the United States, second only to lung cancer [1]. The Taiwan Cancer Registry report showed that in 2014, CRC was the most frequent cancer in men and second most frequent in women [2]. According to the latest updated data from Taiwan Office of Statistics under the Ministry of Health and Welfare, CRC ranked third among men and women in terms of mortality rate in 2017. In 2007, 19.5 out of every 100,000 people died of CRC, which increased to 24.7 out of 100,000 in 2017.
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