Colorectal cancer survival lower in Europe than in US
Last Updated: February 16, 2005



NEW YORK (Reuters Health) - Overall colorectal cancer survival is
lower in Europe than in the United States, largely due to differences
in diagnosis and treatment, according to a report in the February
edition of Gut.


These findings suggest that the "differences in survival observed
between the USA and Europe are real, and reflect earlier diagnosis in
the USA," Dr. Laura Ciccolallo from Istituto Nazionale per lo Studio
e la Cura dei Tumori, Milan, told Reuters Health. "This is important,
because it suggests in turn that the lower survival in Europe is a
problem that is potentially remediable if adequate attention can be
given to earlier diagnosis and more rapid investigation and
treatment."

Dr. Ciccolallo and colleagues used data from 10 population-based
cancer registries to examine the extent to which disease stage,
staging procedures, and treatment explain the differences in
colorectal cancer survival between European and US populations in
1990.

The relative excess risk of death 3 years after diagnosis of
colorectal cancer was 1.26- to 2.21-fold higher in Europe than in the
US, the authors report. The relative excess risks were even higher
after adjustment for age, sex, and primary site.

Excess mortality in Europe was highest during the first year after
diagnosis, the investigators note, and was higher for women and for
patients of advanced age.

More cancers in the US (54%) than in Europe (48%) were diagnosed at
Dukes' stage A or B, the report indicates, and more patients in the
US (92%) than in Europe (85%) were surgically resected.

More than twice as many patients in the US (28%) than in Europe (13%)
had 12 or more lymph nodes examined by the pathologist, the results
indicate.

Within the same category of Dukes' stage and number of nodes
examined, 3-year survival was similar in Europe and the USA, the
researchers note.

"The differences in survival between the USA and Europe are likely to
reflect differences in the speed of diagnosis and the stage of
disease at least as much as any differences in the efficacy of
treatment," Dr. Ciccolallo added.