The National Cancer Data Base. Report on colon cancer

Area of Science:

• Oncology
• Cancer Epidemiology
• Clinical Research

Background:

• The Commission on Cancer's National Cancer Data Base (NCDB) tracks cancer stage, treatment, and survival trends.
• This analysis focuses on the most current (1993) data for colon cancer patients.

Purpose of the Study:

• To describe time trends in stage of disease, treatment patterns, and survival for colon cancer patients using NCDB data.
• To identify demographic and clinical factors influencing colon cancer presentation and outcomes.

Main Methods:

• Utilized NCDB data from 1985-1993, encompassing over 3.7 million cancer cases.
• Specifically analyzed 36,937 colon cancer cases from 1988 and 44,812 from 1993.

Main Results:

• Elderly patients (>80 years) presented with earlier stage disease compared to younger individuals.
• African-Americans showed a slightly higher incidence of Stage IV disease.
• A trend of proximal migration of colon cancer primaries was observed (right colon: 54.7% in 1993 vs. 50.9% in 1988).
• Adjuvant chemotherapy in Stage III colon cancer patients correlated with a 5% improvement in 5-year relative survival.

Conclusions:

• NCDB data effectively report U.S. cancer treatment administration and outcomes.
• Cancer grade appears to have a significant biologic role.
• While outcomes are similar across ethnic groups, disparities in medical care access may persist for African-Americans.
• The benefit of adjuvant therapy for Stage III colon cancer is increasingly recognized.