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Colorectal Cancer

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Geriatric Gastroenterology

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Abstract

Colorectal cancer (CRC) is predominantly a disease of older adults with median age of 70 years at diagnosis. Several risk factors, disease associations, and potential protective factors are known. Chemoprevention is of no proven benefit. Utilization of screening strategies has resulted in decreased incidence and mortality from CRC. Current evidence suggests that select older adults derive benefit with chemotherapy comparable to younger individuals both in adjuvant and metastatic settings. Treatment is best tailored incorporating comorbidities and other contributors of frailty. Molecular markers are increasingly useful in the diagnosis and treatment of CRC.

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References

  1. http://www.census.gov/population/www/projections/files/nation/summary/np2008-t2.xls. Accessed 23 May 2011.

  2. Altekruse SF, Kosary CL, Krapcho M, et al. (eds). SEER Cancer Statistics Review, 1975–2007. Bethesda, MD: National Cancer Institute. http://seer.cancer.gov/csr/1975_2007/, based on November 2009 SEER data submission, posted to the SEER web site; 2010.

  3. Edwards BK, Ward E, Kohler BA, et al. Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer. 2010;116(3):544–73.

    Article  PubMed  Google Scholar 

  4. Souglakos J. Genetic alterations in sporadic and hereditary colorectal cancer: implementations for screening and follow-up. Dig Dis. 2007;25(1):9–19.

    Article  PubMed  Google Scholar 

  5. Rex DK, Lehman GA, Ulbright TM, et al. Colonic neoplasia in asymptomatic persons with negative fecal occult blood tests: influence of age, gender, and family history. Am J Gastroenterol. 1993;88(6):825.

    PubMed  CAS  Google Scholar 

  6. Markowitz SD, Bertagnolli MM. Molecular basis of colorectal cancer. N Engl J Med. 2009;361:2449–60.

    Article  PubMed  CAS  Google Scholar 

  7. Lines LM, Lang K, Lee DW, et al. Trends in stage distribution and survival among elderly colorectal cancer patients in the U.S. J Clin Oncol (Meeting Abstracts). 2008;26(15S):4043.

    Google Scholar 

  8. Onozato W, Yamashita K, Yamashita K, et al. Genetic alterations of K-ras may reflect prognosis in stage III colon cancer patients below 60 years of age. J Surg Oncol. 2011;103(1):25–33.

    Article  PubMed  CAS  Google Scholar 

  9. Hurria A, Gupta S, Zauderer M, et al. Developing a cancer-specific geriatric assessment: a feasibility study. Cancer. 2005;104(9): 1998–2005.

    Article  PubMed  Google Scholar 

  10. Simmonds PD, Best L, George S, et al., Colorectal Cancer Collaborative Group. Surgery for colorectal cancer in elderly patients: a systematic review. Lancet. 2000;356(9234):956.

    Google Scholar 

  11. Faiz O, Haji A, Bottle A, et al. Elective colonic surgery for cancer in the elderly: an investigation into postoperative mortality in English NHS hospitals between 1996 and 2007. Colorectal Dis. 2011;13(7):779–85.

    Google Scholar 

  12. Pallis AG, Papamichael D, Audisio R, et al. EORTC Elderly Task Force experts’ opinion for the treatment of colon cancer in older patients. Cancer Treat Rev. 2010;36(1):83–90. Epub 2009 Nov 26.

    Article  PubMed  CAS  Google Scholar 

  13. Kahn KL, Adams JL, Weeks JC, et al. Adjuvant chemotherapy use and adverse events among older patients with stage III colon cancer. JAMA. 2010;303(11):1037–45.

    Article  PubMed  CAS  Google Scholar 

  14. Patwardhan MB, Samsa GP, McCrory DC, et al. Cancer Care Quality Measures: Diagnosis and Treatment of Colorectal Cancer. Evidence Report/Technology Assessment No. 138. Prepared by the Duke Evidence-based Practice Center under Contract No. 290-02-0025. AHRQ Publication No. 06-E002. Rockville, MD: Agency for Healthcare Research and Quality; May 2006.

    Google Scholar 

  15. Blinman P, Duric V, Nowak AK, et al. Adjuvant chemotherapy for early colon cancer: what survival benefits make it worthwhile? Eur J Cancer. 2010;46(10):1800–7.

    Article  PubMed  CAS  Google Scholar 

  16. Des Guetz G, Uzzan B, Morere JF, Perret G, Nicolas P. Duration of adjuvant chemotherapy for patients with non-metastatic colorectal cancer. Cochrane Database Syst Rev. 2010;(1):CD007046. doi:10.1002/14651858.CD007046.pub2.

  17. Ades S. Adjuvant chemotherapy for colon cancer in the elderly: moving from evidence to practice. Oncology (Williston Park). 2009;23(2):162–7.

    Google Scholar 

  18. McCleary J, Meyerhardt E, Green G, et al. Impact of older age on the efficacy of newer adjuvant therapies in > 12,500 patients (pts) with stage II/III colon cancer: findings from the accent database. J Clin Oncol. 2009;27(Suppl):15s (Abstract 4010).

    Google Scholar 

  19. Marshall JL. Risk assessment in stage II colorectal cancer. Oncology. 2010;24 Suppl 1:9–13.

    PubMed  Google Scholar 

  20. https://www.adjuvantonline.com/index.jsp. Accessed 23 May 2011.

  21. Sargent DJ, Marsoni S, Monges G, et al. Defective mismatch repair as a predictive marker for lack of efficacy of fluorouracil-based adjuvant therapy in colon cancer. J Clin Oncol. 2010;28(20): 3219–26. Epub 2010 May 24.

    Article  PubMed  CAS  Google Scholar 

  22. Kopetz S, Chang GJ, Overman MJ, et al. Improved survival in ­metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol. 2009;27(22): 3677–83. Epub 2009 May 26.

    Article  PubMed  Google Scholar 

  23. Van Cutsem E, Peeters M, Siena S, et al. Open-label phase III trial of panitumumab plus best supportive care compared with best ­supportive care alone in patients with chemotherapy-refractory metastatic colorectal cancer. J Clin Oncol. 2007;25(13):1658–64.

    Article  PubMed  Google Scholar 

  24. Raftery L, Sanoff HK, Goldberg R. Colon cancer in older adults. Semin Oncol. 2008;35(6):561–8.

    Article  PubMed  CAS  Google Scholar 

  25. Pasetto LM, Basso U, Friso ML, et al. Determining therapeutic approaches in the elderly with rectal cancer. Drugs Aging. 2007; 24(9):781–90.

    Article  PubMed  Google Scholar 

  26. Chang GJ, Skibber JM, Feig BW, et al. Are we undertreating rectal cancer in the elderly? An epidemiologic study. Ann Surg. 2007; 246(2):215–21.

    Article  PubMed  Google Scholar 

  27. Endreseth BH, Romundstad P, Myrvold HE, et al. Rectal cancer treatment of the elderly. Colorectal Dis. 2006;8(6):471–9.

    Article  PubMed  CAS  Google Scholar 

  28. National Comprehensive Cancer Network. (2011). http://www.nccn.org/professionals/physician_gls/PDF/colon.pdf. Accessed 23 May 2011.

  29. Lichtman SM, Boparai MK. Anticancer drug therapy in the older cancer patient: pharmacology and polypharmacy. Curr Treat Options Oncol. 2008;9:191–203.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Medical Oncology, Ephrata Cancer Center, 460 N Reading Road, Ephrata, PA, 17522, USA

    Giridhar U. Adiga MD, FACP

  2. Division of Hematology/Oncology, Department of Medicine, Continuum Cancer Centers, St. Luke’s Roosevelt Hospital Center, New York, NY, USA

    Janice P. Dutcher MD

Authors
  1. Giridhar U. Adiga MD, FACP
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  2. Janice P. Dutcher MD
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Corresponding author

Correspondence to Giridhar U. Adiga MD, FACP .

Editor information

Editors and Affiliations

  1. Hospital, Department of Medicine, Saint Peter’s University, 254 Easton Ave, New Brunswick, 08901, New Jersey, USA

    C. S. Pitchumoni

  2. (North Division), Department of Medicine, Montefiore Medical Center, 600 East 233rd Street, Bronx, 10466, New York, USA

    T. S. Dharmarajan

Definitions

Annual percent change (APC)

The average annual percent change over several years. The APC is used to measure trends or the change in rates over time. For information on how this is calculated, go to Trend Algortihms in the SEER*Stat Help system. The calculation involves fitting a straight line to the natural logarithm of the data when it is displayed by calendar year.

Joinpoint analyses

A statistical model for characterizing cancer trends which uses statistical criteria to determine how many times and when the trends in incidence or mortality rates have changed. The results of joinpoint are given as calendar year ranges and the annual percent change (APC) in the rates over each period.

Survival rates

Survival examines how long after diagnosis people live. Cancer survival is measured in a number of different ways depending on the intended purpose.

Relative survival rate

A measure of net survival that is calculated by comparing observed (overall) survival with expected survival from a comparable set of people who do not have cancer to measure the excess mortality that is associated with a cancer diagnosis.

Stage distribution

Stage provides a measure of disease progression, detailing the degree to which the cancer has advanced. Two methods commonly used to determine stage are AJCC and SEER Summary Stage. The AJCC method (see Collaborative Staging Method) is more commonly used in the clinical settings, while SEER has strived to provide consistent definitions over time with their Local/Regional/Distant staging.

Lifetime risk

The probability of developing cancer in the course of one’s lifespan. Lifetime risk may also be discussed in terms of the probability of developing or of dying from cancer. Based on cancer rates from 2004 to 2006, it was estimated that men had about a 44% chance of developing cancer in their lifetimes, while women had about a 38% chance.

Probability of developing cancer

The chance that a person will develop cancer in his/her lifetime.

Prevalence

The number of people who have received a ­diagnosis of cancer during a defined time period, and who are alive on the last day of that period. Most prevalence data in SEER is for limited duration because information on cases diagnosed before 1973 is not generally available. (http://seer.cancer.gov/statfacts/html/colorect.html) (Accessed May 23, 2011).

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Adiga, G.U., Dutcher, J.P. (2012). Colorectal Cancer. In: Pitchumoni, C., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1623-5_63

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  • DOI: https://doi.org/10.1007/978-1-4419-1623-5_63

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  • Publisher Name: Springer, New York, NY

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  • Online ISBN: 978-1-4419-1623-5

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