Sutter Health Cancer Services and Programs

C o l o r e c t a l C a n c e r ( 1 9 9 5 - 2 0 0 4 )FOCUSat Sutter HealthFive-Year Relative SurvivalIn order to directly compare survival rates for Sutter Health colorectal cancerpatients with the most recently available national data, 3 we calculated relativesurvival 4 for patients diagnosed in the 1995–2002 time period (Figure 15, page 27).Overall we find that five-year relative survival rates for both colon (64%) and rectal(67%) are comparable to those reported for the SEER U.S. population (63% and64%, respectively). Also, the Sutter Health data continue to reflect a trend for lowersurvival in African-Americans compared with Caucasians, which has been observednationally for many years.Alta Bates Comprehensive Cancer Center, a program ofAlta Bates Summit Medical CenterThe variability seen in survival values in Figure 15 is likely due to a combinationof factors, including stage mix, racial mix and small sample size. Figure 16 (page27) shows the important role that stage at diagnosis plays in determining fiveyearsurvival for colorectal cancer. In particular, patients with stage IV diseasehave dramatically reduced survival (7% and 12 % for colon and rectal cancers,respectively). Compared to other racial groups, African-Americans in the SutterHealth colorectal cancer population have the highest proportion of stage IV diseaseand the lowest proportion of stage I disease. These data are consistent with nationaltrends and may explain why hospitals with large African-American components(e.g., ABMC and SMC) show slightly reduced overall survival. Also of note,SRMC’s relatively low rectal cancer survival likely results from it having the highestproportion of stage IV patients (17%) among the Sutter institutions, combined witha small sample size.3SEER Public Use CD-ROM, 20054Relative survival data must be interpreted with caution.The relative survival rate facilitates comparison ofsurvival data from different groups of patients by takinginto consideration the likelihood that patients in a givenage group will die from causes unrelated to their cancer.Relative survival adjusts the actual observed survivalrates of a given patient population for the population’sage and gender structure relative to a “standard” U.S.population. This adjustment doesn’t take into accountfactors such as race and socioeconomic status, whichare known to affect survival rates for persons withcolorectal cancer. Also, the U.S. five-year relative survivalvalue used in this report for comparison purposes isbased upon SEER data obtained from population-basedcancer registries covering only about 10% of the U.S.population. To the extent that the patients seen at SutterHealth facilities during the 1995–2002 period differ fromthe U.S. subpopulation utilized for the SEER statistics,comparisons must be made with caution. Finally,comparisons among Sutter Health facilities with respectto survival rates must take into account the demographicvariability seen across Sutter Health institutions.ConclusionThis report reviews Sutter Health colorectal cancer data for the 10–year time period1995–2004. Where appropriate we have used 1989–94 data from our 2000 colorectalreport to give a 16–year time dimension to this study (1989–2004). Remarkably, littlehas changed during this 16–year period.Early diagnosis results in improved survival. It also allows for the option of lessinvasive surgery, particularly for rectal cancer, and can eliminate the need foradjuvant chemotherapy for either condition. Earlier diagnosis of rectal cancerobviates the need for radiation therapy, which has become a standard for stage IIand III rectal cancer.Our mission should be clear. Locally and nationally, our efforts to screen patients forcolorectal cancer must improve. A variety of techniques is considered acceptable.We must establish a concerted effort with our patients and primary care physiciansand facilitate the process to ease the ever-increasing burden on our primary carephysicians, improve our efforts in public education and ensure ready access toscreening for our patients.18 | 2005 Annual Cancer Center Report — 2004 Statistical Review