The North Pacific Surgical AssociationDisparities in the treatment of colon cancer in octogenarians
Section snippets
Database
The Oregon Health & Science University Institution Review Board and the Oregon State Cancer Registry (OSCaR) Review Board both approved this study. OSCaR provided de-identified data on demographics, stage, and initial therapy for 10,433 patients with primary colon tumors diagnosed from 1998 through 2004. These data were entered into SPSS 15.0 (SPSS Inc., Chicago, IL). The age at diagnosis was used to categorize the patients into being 80 and older or 79 and younger. Rural and urban designations
Demographics
Of the 10,433 patients, 7,354 (70.5%) were ≤79 and 3,789 (29.5%) were ≥80 years old. Patients ≥80 years of age were more likely to be female and less likely to live in a rural county than the younger patients (Table 1).
Tumor characteristics and stage at diagnosis
Older patients were less likely to have stages in situ, regional to lymph node direct extension, or distant metastatic disease at presentation, but they were more likely than younger patients to have disease that was regional by direct extension or unknown stage (Figure 1).
Comments
The US population is becoming increasingly older, but data on how best to care for these patients are sparse. The purpose of this study was to examine disparities in treatment of colon cancer related to age using a large state database. Unfortunately, much of the key research guiding our current standard of care for diseases such as colon cancer has not included those over 80 years of age. This may in part be due to the ever-changing definition of “elderly.”
In our study, about a third of
Acknowledgment
The authors would like to acknowledge the hard work of the staff of the Oregon State Cancer Registry, Oregon Department of Human Services, Portland, OR.
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Supported by the Oregon Clinical and Translational Research Institute (OCTRI), grant number UL1 RR024140 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research.