LOS ANGELES — Between 1992 and 2002, only 70% of patients who underwent colorectal cancer resection received recommended surveillance at 3 years, results from a large analysis showed.
The surveillance rate at 1 year was much lower—26%—but that figure “can be deceiving because we looked specifically at [surveillance] 12 months post procedure. So if somebody got screened at 15 months, we're not necessarily going to pick that up,” lead study author Dr. Harry L. Reynolds said in an interview during a poster session at the annual Digestive Disease Week.
A more realistic number to look at would be the 3-year mark, he said. But even at 3 years, “we're not where we need to be in terms of screening or surveying our postop colectomy/proctectomy patients,” said Dr. Reynolds of the colorectal surgery division at University Hospitals of Cleveland.
He and his associates used a linked Surveillance Epidemiology and End Results Medicare database to identify patients with colorectal carcinoma who underwent colectomy and/or proctectomy between 1992 and 2002. Patients included in the analysis were age 65 or older, were not in an HMO, were enrolled in Medicare Part B, and underwent surgical resection for a stage I-III colorectal cancer.
The mean age of the patients was 77 years. Most (75%) had undergone surgery for colon cancer, while 25% had undergone surgery for rectal cancer. Dr. Reynolds and his associates reported that 62,882 patients survived 1 year after surgical resection and 35,784 survived through 3 years.
Fewer numbers of African Americans and Hispanics (63% and 66%, respectively) received surveillance at 3 years, compared with whites and Asians (71% and 70%, respectively). The differences were statistically significant “but the actual variations aren't huge,” Dr. Reynolds said. Reasons for the differences are not known, he added, but “there may be some regional differences in access to care, [and] there may be some economic issues.” Variation in the surveillance rates was also seen among the 13 different geographic regions used in the analysis, ranging from 23% to 33% at 1 year and 67% to 76% at 3 years.
The American Cancer Society and the National Cancer Institute supported the study.