Background Little is known about colorectal cancer or colon and rectal cancer. Are they the same disease or different diseases? Objectives The aim of this epidemiology study was to compare the features of colon and rectal cancer by using recent national cancer surveillance data. Design and setting Data included colorectal cancer (1995–2008) from the Surveillance, Epidemiology, and End Results Program (SEER) database. Only adenocarcinoma was included for analysis. Patients A total of 372,130 patients with a median follow-up of 32 months were analyzed. Main outcome measures Mean survival of patients with the same stage of colon and rectal cancer was evaluated. Results Around 35% of patients had stage information. Among them, colon cancer patients had better survival than those with rectal cancer, by a margin of 4 months in stage IIB. In stage IIIC and stage IV, rectal cancer patients had better survival than colon cancer patients, by about 3 months. Stage IIB colorectal cancer patients had a poorer prognosis than those with stage IIIA and IIIB colorectal cancer. After adjustment of age, sex and race, colon cancer patients had better survival than rectal cancer of stage IIB, but in stage IIIC and IV, rectal cancer patients had better survival than colon cancer. Limitations The study is limited by its retrospective nature. Conclusion This was a population-based study. The prognosis of rectal cancer was not worse than that of colon cancer. Local advanced colorectal cancer had a poorer prognosis than local regional lymph node metastasis. Stage IIB might require more aggressive chemotherapy, and no less than that for stage III.
Jenab M, Bueno-de-Mesquita HB, Ferrari P, van Duijnhoven FJ, Norat T, et al. (2010) Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study. BMJ 340: b5500.
de Vogel S, Dindore V, van Engeland M, Goldbohm RA, van den Brandt PA, et al. (2008) Dietary folate, methionine, riboflavin, and vitamin B-6 and risk of sporadic colorectal cancer. The Journal Of Nutrition 138: 2372–2378.
Zschabitz S, Cheng TY, Neuhouser ML, Zheng Y, Ray RM, et al. (2013) B vitamin intakes and incidence of colorectal cancer: results from the Women’s Health Initiative Observational Study cohort. Am J Clin Nutr 97: 332–343.
Harnack L, Jacobs DR Jr, Nicodemus K, Lazovich D, Anderson K, et al. (2002) Relationship of folate, vitamin B-6, vitamin B-12, and methionine intake to incidence of colorectal cancers. Nutr Cancer 43: 152–158.
Harriss DJ, Atkinson G, Batterham A, George K, Cable NT, et al. (2009) Lifestyle factors and colorectal cancer risk (2): a systematic review and meta-analysis of associations with leisure-time physical activity. Colorectal Dis 11: 689–701.
Gong J, Hutter C, Baron JA, Berndt S, Caan B, et al. (2012) A pooled analysis of smoking and colorectal cancer: timing of exposure and interactions with environmental factors. Cancer Epidemiol Biomarkers Prev 21: 1974–1985.
Aamodt R, Jonsdottir K, Andersen SN, Bondi J, Bukholm G, et al. (2009) Differences in protein expression and gene amplification of cyclins between colon and rectal adenocarcinomas. Gastroenterol Res Pract 2009: 285830.
Erben P, Strobel P, Horisberger K, Popa J, Bohn B, et al. (2011) KRAS and BRAF mutations and PTEN expression do not predict efficacy of cetuximab-based chemoradiotherapy in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 81: 1032–1038.
Davies JM, Trembath D, Deal AM, Funkhouser WK, Calvo BF, et al. (2011) Phospho-ERK and AKT status, but not KRAS mutation status, are associated with outcomes in rectal cancer treated with chemoradiotherapy. Radiat Oncol 6: 114.
Luna-Perez P, Segura J, Alvarado I, Labastida S, Santiago-Payan H, et al. (2000) Specific c-K-ras gene mutations as a tumor-response marker in locally advanced rectal cancer treated with preoperative chemoradiotherapy. Ann Surg Oncol 7: 727–731.
McDermott FT, Hughes ES, Pihl E, Milne BJ, Price AB (1981) Comparative results of surgical management of single carcinomas of the colon and rectum: a series of 1939 patients managed by one surgeon. Br J Surg 68: 850–855.