Patients with colorectal cancer in England have lower survival rates than patients in Denmark, Norway and Sweden, according to new research published in the Lancet Oncology.
The population-based study collected data from all patients aged 18-99 years diagnosed with primary, invasive, colorectal adenocarcinoma from 1 January 2010 to 31 December 2012, in Denmark (n=12,958), England (n=97,466), Norway (n=11,450) and Sweden (n=17,583), from national colorectal cancer registries.
Three-year colon cancer survival was lower in England (63.9%) and Denmark (65.7%) than in Norway (69.5%) and Sweden (72.1%). Rectal cancer survival was lower in England (69.7%) than in the other 3 countries (Denmark, 72.5%; Sweden, 74.1%; and Norway, 75.0%).
There were no significant differences in survival for patients with stage I disease in any of the 4 countries. Three-year survival after stage II or III rectal cancer and stage IV colon cancer was consistently lower in England (86.4%; 75.5%; and 20.5%, respectively) than in Norway (94.1%; 83.4%; and 33.0%, respectively) and Sweden (92.9%; 80.6%; and 23.7%, respectively).
The proportion of patients treated with resectional surgery ranged from 68.4% in England to 81.3% in Sweden for colon cancer, and from 59.9% in England to 70.8% in Sweden for rectal cancer. This range was widest for patients older than 75 years.
The authors concluded that differences in patient selection for surgery, especially in patients older than 75 years or individuals with advanced disease, might partly explain the differences in survival.
