Kenjiro Kotake1, Michio Asano2, Heita Ozawa3, Hirotoshi Kobayashi4, Kenichi Sugihara4. 1. Department of Colorectal Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan. kkotake@tcc.pref.tochigi.lg.jp. 2. Department of Surgery, Asano Clinic, 1628-1 Takatsuka-cho, Hamamatsu, Shizuoka, 432-8061, Japan. 3. Department of Colorectal Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan. 4. Department of Surgical Oncology, Graduate School, Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Abstract
BACKGROUND: A gender difference in survival has been documented in colorectal cancer (CRC) patients, although the underlying mechanism remains undefined. This study aimed to gain improved insight into this difference, with a special focus on improved cancer-specific survival. METHODS: The study population consisted of 82,402 patients with invasive CRC who had undergone surgery in Japan between 1985 and 2004. To estimate improved survival, multivariate adjustment using patient demographics and tumor characteristics was performed. RESULTS: Patient characteristics changed over time. The 5-year survival rates increased from 66.5 to 76.3 % during the study period. Higher survival rates persisted in women over time (multivariate-adjustment model-hazard ratio [HR] 0.87, 95 % confidence interval [CI] 0.85-0.90). Patients who received surgery during the period 2000-2004 had significantly longer survival than those during the period 1985-1989 (men: HR 0.70, 95 % CI 0.67-0.74; women: HR 0.72, 95 % CI 0.67-0.76). However, there was no gender difference regarding improved survival. CONCLUSIONS: A reduced risk of cancer-specific death for women relative to men persisted over time; however, enhancement of survival was equally observed in both genders. Identification of factors associated with gender differences and changes over time in CRC survival may serve as targets for further improvement.
BACKGROUND: A gender difference in survival has been documented in colorectal cancer (CRC) patients, although the underlying mechanism remains undefined. This study aimed to gain improved insight into this difference, with a special focus on improved cancer-specific survival. METHODS: The study population consisted of 82,402 patients with invasive CRC who had undergone surgery in Japan between 1985 and 2004. To estimate improved survival, multivariate adjustment using patient demographics and tumor characteristics was performed. RESULTS:Patient characteristics changed over time. The 5-year survival rates increased from 66.5 to 76.3 % during the study period. Higher survival rates persisted in women over time (multivariate-adjustment model-hazard ratio [HR] 0.87, 95 % confidence interval [CI] 0.85-0.90). Patients who received surgery during the period 2000-2004 had significantly longer survival than those during the period 1985-1989 (men: HR 0.70, 95 % CI 0.67-0.74; women: HR 0.72, 95 % CI 0.67-0.76). However, there was no gender difference regarding improved survival. CONCLUSIONS: A reduced risk of cancer-specific death for women relative to men persisted over time; however, enhancement of survival was equally observed in both genders. Identification of factors associated with gender differences and changes over time in CRC survival may serve as targets for further improvement.
Entities:
Keywords:
Cancer specific survival; Colorectal cancer; Gender differences; Improvement in survival
Authors: Scott Kopetz; George J Chang; Michael J Overman; Cathy Eng; Daniel J Sargent; David W Larson; Axel Grothey; Jean-Nicolas Vauthey; David M Nagorney; Robert R McWilliams Journal: J Clin Oncol Date: 2009-05-26 Impact factor: 44.544
Authors: Rainer Fietkau; Claus Rödel; Werner Hohenberger; Rudolf Raab; Clemens Hess; Torsten Liersch; Heinz Becker; Christian Wittekind; Matthias Hutter; Eva Hager; Johann Karstens; Hermann Ewald; Norbert Christen; Michael Jagoditsch; Peter Martus; Rolf Sauer Journal: Int J Radiat Oncol Biol Phys Date: 2006-12-29 Impact factor: 7.038
Authors: S Ogino; M Cantor; T Kawasaki; M Brahmandam; G J Kirkner; D J Weisenberger; M Campan; P W Laird; M Loda; C S Fuchs Journal: Gut Date: 2006-01-11 Impact factor: 23.059
Authors: Claudia Allemani; Hannah K Weir; Helena Carreira; Rhea Harewood; Devon Spika; Xiao-Si Wang; Finian Bannon; Jane V Ahn; Christopher J Johnson; Audrey Bonaventure; Rafael Marcos-Gragera; Charles Stiller; Gulnar Azevedo e Silva; Wan-Qing Chen; Olufemi J Ogunbiyi; Bernard Rachet; Matthew J Soeberg; Hui You; Tomohiro Matsuda; Magdalena Bielska-Lasota; Hans Storm; Thomas C Tucker; Michel P Coleman Journal: Lancet Date: 2014-11-26 Impact factor: 79.321
Authors: Jung Won Park; Jin Ha Lee; Ye Hyun Park; Soo Jung Park; Jae Hee Cheon; Won Ho Kim; Tae Il Kim Journal: World J Gastroenterol Date: 2017-07-28 Impact factor: 5.742
Authors: Alan White; Lucy Ironmonger; Robert J C Steele; Nick Ormiston-Smith; Carina Crawford; Amanda Seims Journal: BMC Cancer Date: 2018-09-20 Impact factor: 4.430
Authors: Young-Jae Hwang; Dong Woo Shin; Nayoung Kim; Hyuk Yoon; Cheol Min Shin; Young Soo Park; Dong Ho Lee Journal: Korean J Intern Med Date: 2020-06-22 Impact factor: 2.884